Living Beyond Breast Cancer
Living Beyond Breast Cancer is a national nonprofit that connects people with trusted information and a community of support.
Mastectomy
A procedure to treat breast cancer or reduce your risk—with support every step of the way
A mastectomy is a surgery to remove the breast to treat breast cancer or reduce the risk for disease for people at high risk. This can be a difficult treatment decision for some people, and it’s important to talk to your doctor about your goals and concerns.
A mastectomy is a surgery to remove all breast tissue to treat or reduce the risk of breast cancer. Your doctor may recommend a mastectomy if you have:
- A large tumor
- Cancer that has spread to multiple spots in the breast
- Inflammatory breast cancer, an aggressive disease that affects the skin on the breast
Some patients who have early-stage cancer or a small tumor can undergo a partial mastectomy, or lumpectomy, followed by radiation. However, that is not an option for everyone.
If mastectomy is a treatment option for you, your doctor will also talk to you about breast reconstruction surgery. This optional surgery restores the look and feel of your breasts after a mastectomy. While some people choose to not have their breasts reconstructed after surgery (also called ‘going flat’), your goals for reconstruction will affect the type of mastectomy your doctor recommends.
There are several categories for this type of surgery:
- Skin-sparing mastectomy – This surgery removes all the breast tissue and the nipple, leaving only the skin of the breast. This is done for patients who want breast reconstruction surgery.
- Nipple-sparing mastectomy – This surgery removes all breast tissue, but keeps the skin, nipple and areola (the skin around the nipple). Not everyone is eligible for this surgery, especially if your cancer is located near the nipple. This type of surgery maintains the look of the breast and is immediately followed by reconstruction.
- Total (simple) mastectomy – This procedure removes the entire breast, nipple and skin, leaving behind a flat area. This is an option for people who do not want reconstruction.
- Modified radical mastectomy – This procedure refers to any type of mastectomy but also includes removing all the lymph nodes under your arm.
Some people with a high risk for breast cancer may choose to have their breasts remove before they develop disease. This is called a prophylactic mastectomy. People who choose this type of mastectomy typically have a strong family history of breast cancer or have a genetic mutation that puts them at a high lifetime risk of breast cancer.
What to Expect with Mastectomy
A mastectomy is a surgery to remove all breast tissue to treat or reduce the risk of breast cancer. Your doctor may recommend a mastectomy if you have:
- A large tumor
- Cancer that has spread to multiple spots in the breast
- Inflammatory breast cancer, an aggressive disease that affects the skin on the breast
Some patients who have early-stage cancer or a small tumor can undergo a partial mastectomy, or lumpectomy, followed by radiation. However, that is not an option for everyone.
If mastectomy is a treatment option for you, your doctor will also talk to you about breast reconstruction surgery. This optional surgery restores the look and feel of your breasts after a mastectomy. While some people choose to not have their breasts reconstructed after surgery (also called ‘going flat’), your goals for reconstruction will affect the type of mastectomy your doctor recommends.
There are several categories for this type of surgery:
- Skin-sparing mastectomy – This surgery removes all the breast tissue and the nipple, leaving only the skin of the breast. This is done for patients who want breast reconstruction surgery.
- Nipple-sparing mastectomy – This surgery removes all breast tissue, but keeps the skin, nipple and areola (the skin around the nipple). Not everyone is eligible for this surgery, especially if your cancer is located near the nipple. This type of surgery maintains the look of the breast and is immediately followed by reconstruction.
- Total (simple) mastectomy – This procedure removes the entire breast, nipple and skin, leaving behind a flat area. This is an option for people who do not want reconstruction.
- Modified radical mastectomy – This procedure refers to any type of mastectomy but also includes removing all the lymph nodes under your arm.
Some people with a high risk for breast cancer may choose to have their breasts remove before they develop disease. This is called a prophylactic mastectomy. People who choose this type of mastectomy typically have a strong family history of breast cancer or have a genetic mutation that puts them at a high lifetime risk of breast cancer.
You will have in-depth conversations with your doctor about the plan for your mastectomy (and reconstruction, if you choose.) Each surgery can look very different.
Mastectomy with reconstruction is a two-stage procedure:
- Your breast surgeon and plastic surgeon will work together to remove your breast tissue and begin reconstruction in the first procedure.
- A tissue expander is often placed during the initial operation. Based on your body, goals and wishes, your doctors will sometimes begin breast reconstruction using an implant or a flap of your own tissue from another part of your body. This is also when you can choose to have a flat closure without reconstruction.
Tissue expander devices stretch the skin over time to make room for reconstructing a breast. Tissue expanders require a follow-up surgery with the plastic surgeon to place the implant or flap tissue.
Preparing for Mastectomy
You will have in-depth conversations with your doctor about the plan for your mastectomy (and reconstruction, if you choose.) Each surgery can look very different.
Mastectomy with reconstruction is a two-stage procedure:
- Your breast surgeon and plastic surgeon will work together to remove your breast tissue and begin reconstruction in the first procedure.
- A tissue expander is often placed during the initial operation. Based on your body, goals and wishes, your doctors will sometimes begin breast reconstruction using an implant or a flap of your own tissue from another part of your body. This is also when you can choose to have a flat closure without reconstruction.
Tissue expander devices stretch the skin over time to make room for reconstructing a breast. Tissue expanders require a follow-up surgery with the plastic surgeon to place the implant or flap tissue.
Most people return home the same day or the next day after mastectomy surgery. Your doctor will use interoperative nerve blocks to prevent pain during and immediately after surgery. You will also receive oral pain medications to take at home. At IU Health, a nurse will check on you to ensure you are recovering well.
As you recover, you will likely have a drain in your chest. This soft rubber tube drains excess fluid that collects in the space where the breast tissue was removed. The tube leads to a rubber ball where the fluid is collected. Your surgical care team will explain how to care for the drain at home. If you had lymph nodes removed, your doctor may recommend exercises to improve arm and shoulder movement
You will likely be off work for two to six weeks after surgery, depending on where you work and the type of work you do.
You may have treatment after your mastectomy. Depending on your cancer treatment plans, you may have radiation therapy, chemotherapy, hormone therapy or delayed breast reconstruction surgery.
After a Mastectomy
Most people return home the same day or the next day after mastectomy surgery. Your doctor will use interoperative nerve blocks to prevent pain during and immediately after surgery. You will also receive oral pain medications to take at home. At IU Health, a nurse will check on you to ensure you are recovering well.
As you recover, you will likely have a drain in your chest. This soft rubber tube drains excess fluid that collects in the space where the breast tissue was removed. The tube leads to a rubber ball where the fluid is collected. Your surgical care team will explain how to care for the drain at home. If you had lymph nodes removed, your doctor may recommend exercises to improve arm and shoulder movement
You will likely be off work for two to six weeks after surgery, depending on where you work and the type of work you do.
You may have treatment after your mastectomy. Depending on your cancer treatment plans, you may have radiation therapy, chemotherapy, hormone therapy or delayed breast reconstruction surgery.
- Am I a candidate for breast reconstruction surgery?
- Am I a candidate for a nipple-sparing mastectomy?
- What are the risks and benefits to my options for a mastectomy?
- What are my options for going flat?
Questions to Ask Your Provider
- Am I a candidate for breast reconstruction surgery?
- Am I a candidate for a nipple-sparing mastectomy?
- What are the risks and benefits to my options for a mastectomy?
- What are my options for going flat?
Frequently Asked Questions About Mastectomy
Breast reconstruction after mastectomy
Can I wait to have breast reconstruction surgery until after my mastectomy?
Yes. While most breast reconstruction surgeries happen immediately following a mastectomy, there may be reasons to reconstruct the breast later. It may be helpful to delay reconstruction when treating particularly aggressive cancers or for patients who need follow-up treatments. Some patients simply prefer to wait on making decisions about breast reconstruction until after their cancer treatment is complete.
Do I have to undergo breast reconstruction after a mastectomy?
No. An increasing number of women are choosing to ‘go flat’ after a mastectomy and skip having their breasts reconstructed. Patients choose this option for its faster recovery and to avoid additional surgeries, complications or potential cancer risks in the future. This is a very personal decision that can have its own challenges in creating an aesthetic closure. Discuss your wishes and concerns with your doctor.
Sep 13
Dowd went in for her routine mammogram, and they found a spot. It didn’t take her long to realize she had breast cancer.
Patient Stories for Mastectomy
Sep 13
Dowd went in for her routine mammogram, and they found a spot. It didn’t take her long to realize she had breast cancer.
American Cancer Society
American Cancer Society is an organization working to improve the lives of people with cancer and their families through advocacy, research and patient support.
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Living Beyond Breast Cancer
Living Beyond Breast Cancer is a national nonprofit that connects people with trusted information and a community of support.
American Cancer Society
American Cancer Society is an organization working to improve the lives of people with cancer and their families through advocacy, research and patient support.