Mastectomy

(Breast Surgery; Surgery for Breast Cancer; Surgery to Remove a Breast)

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Definition    TOP

A mastectomy is surgery to remove breast tissue. There are 2 types:

  • Breast-conserving:
    • Lumpectomy—The tumor and some normal tissue around it are taken out.
    • Partial mastectomy—Part of the breast that has cancer and some normal tissue around it are taken out. The lymph nodes or the lining of the chest muscle may also be taken out.
  • Breast-tissue removal mastectomy types:
    • Simple—The whole breast is taken out. This includes the nipple and areola.
    • Skin-sparing—The skin that covers the breast is left except for the nipple and areola. This is like a simple mastectomy. It is done when reconstruction is planned. It has limits and may not be a choice for all women.
    • Modified radical—The whole breast, some lymph nodes in the armpit, and any affected chest muscles are taken out.
    • Radical—The whole breast, lymph nodes, and muscles of the chest wall are taken out (rare).

Mastectomy

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Reasons for Procedure    TOP

A mastectomy is done to:

  • Treat breast cancer —removes cancer cells and any affected tissue
  • Prevent breast cancer—removes one or both breasts in women with a high risk of getting cancer
  • Treat side effects from a past treatment—some people who have immune system problems may not be able to have radiation therapy

Possible Complications    TOP

Problems are rare, but all surgeries have some risk. Your doctor will go over problems that may happen, such as:

  • Bleeding and bruising
  • Seroma—build up of clear fluid in the cut
  • Infection
  • Lymphedema—swelling of the arm caused by a build up of fluid in lymph nodes
  • Poor arm and shoulder movement
  • Numbness of skin on upper arm
  • Burning or stabbing pain

Some factors that may raise the risk of problems are:

What to Expect    TOP

Prior to Procedure

Your doctor may do blood and urine tests.

You should also

  • Talk to your doctor about your medicines and supplements. You may be asked to stop taking some medicines up to 1 week before surgery.
  • Arrange for a ride home.
  • Eat a light meal the night before. Do not eat or drink after midnight.

Anesthesia

You will have general anesthesia. You will be asleep during the procedure.

Description of the Procedure    TOP

For breast-conserving surgery, a cut is made at the site of the tumor. The tumor is taken out. A small bit of normal tissue around it is also taken out.

For breast-tissue removal surgery, the whole breast and fatty tissue are taken out. The doctor may also need to remove lymph nodes and some chest muscles. Tissue that is taken out is studied under a microscope. If you have skin-sparing surgery, the skin around the breast will be kept.

The doctor will place a tube to drain blood and fluids. The site will be closed with stitches.

How Long Will It Take?    TOP

1-3 hours

Will It Hurt?    TOP

Anesthesia will prevent pain during surgery. You will be given medicine for pain after surgery.

Average Hospital Stay    TOP

1-3 days

Post-procedure Care    TOP

At the Hospital

You will be in a room where your blood pressure, pulse, and breathing will be checked. Recovery may also mean:

  • Pain medicines
  • Antibiotics to prevent infection
  • Medication to prevent blood clots
  • Getting out of bed and moving around within 24 hours of your surgery

If you had cancer and it has spread, chemotherapy and radiation therapy may be needed.

During your stay, staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your cuts covered

There are also steps you can take to lower your chances of infection such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not allowing others to touch your cuts

At Home

When you get home:

  • Limit activities until your doctor says it is okay to resume them.
  • Do exercises to promote arm strength. This will prevent fluid build up in your lymph nodes.
  • Follow your doctor’s instructions.

Ask your doctor when you can start wearing a light-weight prosthetic breast. You can be fitted for a more permanent one when the site has healed. If you want a reconstruction, talk to your doctor.

Call Your Doctor    TOP

Call your doctor if you are not getting better or you have problems such as:

  • New signs of infection, such as fever and chills
  • Increased redness, swelling, increasing pain, excessive bleeding, or discharge from the site
  • Cough, breathing problems, or chest pain
  • Nausea and vomiting
  • Redness, warmth, swelling, stiffness, or hardness in the arm or hand on the side of the body where the lymph nodes were taken out
  • New or worsening pain and swelling in your feet, calves, or legs
  • Lumps or skin changes in the tissue that is left on mastectomy side
  • Lumps, skin changes, or nipple drainage in remaining breast
  • Symptoms of depression that last at least 2 weeks or longer

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

American Cancer Society
https://www.cancer.org

CANADIAN RESOURCES:

Canadian Cancer Society
http://www.cancer.ca
Women's Health Matters—Women's College Hospital
http://www.womenshealthmatters.ca

References:

Axillary lymph nodes. Breast Cancer website. Available at:
...(Click grey area to select URL)
Updated September 17, 2012. Accessed December 18, 2017.
Breast cancer in women. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated October 20, 2017. Accessed December 18, 2017.
Surgery for breast cancer. American Cancer Society. Available at: https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer.html. Updated August 18, 2016. Accessed December 18, 2017.
Surgery for early and locally advanced breast cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated May 31, 2017. Accessed December 18, 2017.
Treatments & side effects. Breast Cancer website. Available at:
...(Click grey area to select URL)
Updated July 31, 2017. Accessed December 18, 2017.
Last reviewed December 2017 by EBSCO Medical Review Board Donald W. Buck II, MD
Last Updated: 5/22/2018

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