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What You Need to Know About Having a Mastectomy

Updated on March 6, 2017
Although “mastectomy” is defined as the removal of the entire breast, the actual surgical procedure can be performed five different ways.
Although “mastectomy” is defined as the removal of the entire breast, the actual surgical procedure can be performed five different ways.

Understanding Mastectomy Procedures

If you’ve recently found out you have breast cancer, you certainly have a lot of questions. You’re probably wondering what stage your cancer is, if you need to have chemotherapy or radiation, what the prognosis is, and most of all — will you require a mastectomy?

As it turns out, there is a lot to know about having a mastectomy!

The right type of mastectomy is selected by your surgeon and oncologist based on the type and stage of your breast cancer.

There Are Several Different Types of Mastectomies

Five to be exact!

Although “mastectomy” is defined as the removal of the entire breast, the actual surgical procedure can be performed five different ways:

  1. Simple/total mastectomy. This type of mastectomy involves removal of the entire breast, but no musculature or axillary lymph node dissection. This type of mastectomy is appropriate for women who are having prophylactic mastectomies or who have large areas of ductal carcinoma in situ (DCIS).
  2. Modified radical mastectomy. This type of mastectomy involves removal of the entire breast and several lymph nodes, but no musculature. This is the most common type of mastectomy performed because examining lymph nodes helps to evaluate whether cancer has spread.
  3. Radical mastectomy. This type of mastectomy is the most involved type of mastectomy. It involves removal of the entire breast, along with lymph nodes and musculature of the chest wall under the breast. It is performed when cancer has spread to the muscles below the breast.
  4. Partial mastectomy. Similar to a lumpectomy, a partial mastectomy is the removal of the cancerous tissue without removing the entire breast. However, more tissue is removed than in a lumpectomy.
  5. Nipple-sparing mastectomy. Although all of the breast is removed, the nipple is left in place.

The right type of mastectomy is selected by your surgeon and oncologist based on the type and stage of your breast cancer.

There are typically two types of reconstruction available: implants (with saline or silicone) or natural tissue flaps (using fat and tissue from your own body). Sometimes a combination of the two is an option.
There are typically two types of reconstruction available: implants (with saline or silicone) or natural tissue flaps (using fat and tissue from your own body). Sometimes a combination of the two is an option.

A Mastectomy Is Sometimes Performed to Prevent Breast Cancer

There are women who have a much higher risk of developing breast cancer due to an inherited gene mutation called BRCA1 or BRCA2 (although there are also several other gene mutations). For these women, having a mastectomy performed may prevent them from one day having breast cancer.

When a mastectomy is done preventatively, it is called a prophylactic mastectomy. It can be done on both breasts (bilateral mastectomy).

Women currently battling breast cancer in one breast may also choose to have a mastectomy in their other breast — this is called a contralateral prophylactic mastectomy.

When a mastectomy is done preventatively, it is called a prophylactic mastectomy. It can be done on both breasts (bilateral mastectomy).

Breast Reconstruction Can Often be Performed Immediately

Should you opt for breast reconstruction, often your surgeon may be able to do it immediately. This is not the case or everyone, but likelihood improves if your weight is healthy, you are a nonsmoker and you have no other extremely pressing needs post-surgery.

There are typically two types of reconstruction available: implants (with saline or silicone) or natural tissue flaps (using fat and tissue from your own body). Sometimes a combination of the two is an option.

The pros and cons of each type of reconstructive surgery will be weighed with your surgeon. For example, if you require a shorter recovery time, implants would be more feasible. For women seeking a more natural look, the use of their own body tissues may be more desirable.

Whether you’re heading into a mastectomy surgery with newly diagnosed breast cancer or having a prophylactic mastectomy, a mastectomy is a big surgery.
Whether you’re heading into a mastectomy surgery with newly diagnosed breast cancer or having a prophylactic mastectomy, a mastectomy is a big surgery.

Be Prepared…

Whether you’re heading into a mastectomy surgery with newly diagnosed breast cancer or having a prophylactic mastectomy, a mastectomy is a big surgery. Ask questions.

Understood both your disease and the procedure. Make sure that you understand what is happening. Ask what to expect AFTER the surgery. Inquire about the recovery period so that you can be prepared BEFORE you go in for surgery.

Although this is undoubtedly a terrifying time in your life, being prepared can allay some of your fears.

Written by Krystina Ostermeyer RN, BSN

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    • MsDora profile image

      Dora Weithers 

      20 months ago from The Caribbean

      So informative, also comforting since it reminds us that these procedures are being done all the time, so the woman who has to have the surgery knows that she is not alone. Very helpful!

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