Mastectomy, which combines the two ancient Greek words for ‘breast’ (Mastec-) and ‘cutting out’ (-ektomia), describes the surgical removal of the breast.
Like lumpectomy, it is a surgical procedure used to cut out malignant, or cancerous, tissue and thus prevent the cancer from spreading inside the body. Up until the 1970s, it was the only option available to patients, although now it is possible in many cases (but not in all) to instead opt for breast conservation surgery that does not remove the entire breast.
See the page on lumpectomy for cases where it is generally advised to proceed with a mastectomy. Dr John Gault is able to advise patients on the difficult decision as to whether to proceed with a mastectomy or lumpectomy.
There are several different types of mastectomy:
Total Mastectomy (also known as ‘simple mastectomy’)
This is the ‘normal’ mastectomy, where the breast or breasts are surgically removed, but the lymph nodes in the armpit/s, known as ‘axillary lymph nodes’ are not removed. In this type of surgery usually one of the lymph nodes, the so-called ‘sentinel lymph node’ is removed.
See our separate page on prophylactic mastectomy.
Radical Mastectomy (also known as ‘Halsted mastectomy’)
This was the very first type of mastectomy employed in the late 1800s. It involves the removal of the breast/s, lymph nodes and pectoral muscles behind the breast tissue. Today this procedure is only carried out where cancer has spread to the chest wall and/or muscles, as it is more disfiguring than all other options.
Modified Radical Mastectomy
This describes the procedure where the lymph nodes in the armpit/s and other tissue is removed (the ‘axillary contents’) along with the breast/s. This procedure is recommended where there is spread of cancer to the lymph nodes.
Nipple Sparing Mastectomy
This type of mastectomy involves removing breast tissue within the breast through a small incision, but conserving the nipple, areola and skin. This procedure is used as part of a reconstructive procedure.
Skin Sparing Mastectomy
Skin sparing mastectomy involves removing the breast tissue, nipple and areola while preserving the skin for breast reconstruction.
A mastectomy operation normally takes about one hour to complete and usually requires 1-2 days in hospital. If there is any breast reconstruction surgery involved, a longer stay may be required.
After the operation there may be some pain and / or numbness around the breast/armpit area, which will often subside after two weeks or so. There may also be some fluid that collects below the scar – called a ‘seroma’, and this may need to be drained.
A drain is normally placed during surgery – this is usually removed within a few days. Some patients go home with the drain and have this removed by Dr Gault’s team at the following appointment.
If lymph nodes have been removed from the armpit during surgery this may lead to a condition called lymphoedema, which is swelling in the arm, hand or chest area. Lymphoedema may develop several months or even years after the operation.
Follow this link to more information and resources for living with a mastectomy without reconstruction, it is a UK based organisation called “Flat Friends living with out breast reconstruction”.https://flatfriends.org.uk/