Surgery to the Breast: Mastectomy
Mastectomy removes most breast tissue. The operation, reconstruction choices, and other treatments are tailored to the cancer and the person.
The key things to know
- A larger operation is not automatically more effective for suitable early cancers.
- Reconstruction and flat closure are both valid choices.
- Radiotherapy or drug treatment may still be needed.
When it may be recommended
Mastectomy may be advised when cancer or DCIS is extensive relative to breast size, affects separate areas, or cannot be removed with clear margins and an acceptable result through breast conservation. Previous treatment, genetic risk, radiotherapy considerations, and personal preference may also influence the choice. For suitable early cancers, breast-conserving surgery with radiotherapy offers comparable survival, so a larger operation is not automatically a better one.
Types of operation
A simple mastectomy removes breast tissue and usually the nipple-areola complex. Skin-sparing and, in selected cases, nipple-sparing approaches preserve more of the outer envelope for reconstruction while removing the underlying tissue. Suitability depends on tumour location, skin involvement, blood supply, and other factors. Underarm lymph-node surgery is planned separately; mastectomy does not always require axillary clearance.
Reconstruction or a flat chest
You can discuss immediate reconstruction, reconstruction later, an external breast form, or an aesthetic flat closure. All are valid options. Reconstruction may require several stages and does not restore normal breast sensation or breastfeeding. If radiotherapy may be needed, discuss its effect on the reconstruction plan before surgery. Ask to understand the likely scars, contour, and recovery.
Recovery and the next decisions
Drains, numbness, tightness, and temporary movement limits are common parts of recovery, but the experience varies. Follow your team's wound and shoulder-care advice. Fever, increasing redness, rapidly enlarging swelling, or breathing difficulty requires prompt medical advice, with emergency help for severe symptoms. The final pathology determines whether further medicines or radiotherapy are recommended; mastectomy does not guarantee these treatments will be unnecessary.
Take these questions to your appointment
- Why is mastectomy recommended in my case?
- Can I choose reconstruction or flat closure, and will I need radiotherapy?
Sources & review
This is original educational content based on the sources below, not reproduced textbook material. Website supervisor: Dr. Nizar Ismail. Individual medical review of this article is pending.
- NCI: Surgery for Breast Cancer ↗
- NCI: Choosing Between Lumpectomy and Mastectomy ↗
- NCI: Breast Reconstruction After Mastectomy ↗
This information cannot replace diagnosis or a personal treatment plan. Consult your care team about symptoms or decisions about your treatment.
