A mastectomy is surgery to remove a breast. In the past, a radical mastectomy with complete removal of the breast was the standard treatment for breast cancer. But surgical breakthroughs over the past 2 decades have given women more options than ever before. Less invasive breast-conserving treatments are available to many women.
The type of mastectomy that’s right for you depends on several things, including:
- Your age
- General health
- Menopause status
- Tumor size
- Tumor stage (how far it's spread)
- Tumor grade (its aggressiveness)
- Tumor's hormone receptor status
- Whether or not lymph nodes are involved
Various types of mastectomy are available.
What Is a Total Mastectomy?
Also called simple mastectomy, with this procedure, your doctor removes your entire breast, including the nipple. But your lymph nodes, the small glands that are part of your immune system, aren’t removed.
What Is a Preventive Mastectomy?
Studies show that women with a high risk of breast cancer may be as much as 90% less likely to get the disease after preventive mastectomy.
Usually, a total mastectomy -- removing the entire breast and nipple -- is recommended. In some cases, women have both breasts removed. This is called a double mastectomy.
If you plan to have breast reconstruction, it can be done at the time of the preventive mastectomy (immediate reconstruction) or at a later time (delayed reconstruction). During breast reconstruction, the surgeon may use synthetic implants or tissue flaps from another part of your body to create a breast.
What Is a Partial Mastectomy?
Women with stage I or stage II breast cancer may have this procedure. It’s is a breast-conserving method in which the tumor and the tissue surrounding it are all that’s removed.
The surgery is followed by radiation therapy to the remaining breast tissue. With radiation therapy, powerful X-rays target the breast tissue. The radiation kills cancer cells and prevents them from spreading, or reoccurring.
There are two kinds:
- A lumpectomy removes the tumor and a small cancer-free area of tissue surrounding the tumor.
- A quadrantectomy removes the tumor and more of the breast tissue than a lumpectomy.
In some cases, more surgery is required after a partial mastectomy. Sometimes, if cancer cells are still in breast tissue, it may be necessary to remove the entire breast.
What Is a Radical Mastectomy?
A radical mastectomy is the complete removal of the breast, including the nipple. The surgeon also removes the overlying skin, the muscles beneath the breast, and the lymph nodes. Because radical mastectomy isn't more effective than other less extreme forms of mastectomy, it's rarely performed today. It’s only recommended when the cancer has spread to the chest muscle.
What Is a Modified Radical Mastectomy?
A less traumatic and more widely used procedure is the modified radical mastectomy (MRM). With the modified radical mastectomy, the entire breast is removed as well as the underarm lymph nodes. But chest muscles are left intact. The skin covering the chest wall may or may not be left intact. The procedure may be followed with breast reconstruction.