Modified Radical Mastectomy

When treating breast cancer, a doctor’s goal is to remove all of the cancer -- or as much of it as possible. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers.

It’s especially helpful for treating early-stage breast cancer that has spread to the lymph nodes. Studies show MRM is as effective as a traditional radical mastectomy, but takes much less of a toll on a woman’s appearance. Because of the success with MRMs, traditional radical mastectomies are rarely done today.

What Is Modified Radical Mastectomy?

MRM doesn’t remove chest muscles like a traditional radical mastectomy does.

During the procedure, the surgeon removes the breast, including the skin, breast tissue, areola, and nipple, and most of the lymph nodes under the arm. The lining over the large muscle in the chest is also removed, but the muscle itself is left in place.

Following a traditional radical mastectomy, women often have a hollow in the chest. Because the chest muscle is kept in place with an MRM, this doesn’t happen.

What to Expect During an MRM

The surgery takes about 2 to 4 hours.

While you are under general anesthesia, the surgeon will make a single incision across one side of the chest. The skin is pulled back, and the doctor will remove the entire breast tissue, along with the lining over the pectoralis major. Usually, he’ll remove some of the lymph nodes under your arm as well.

The goal of the surgery is to remove the cancer but preserve as much of the skin and tissue as possible so that you can have breast reconstruction, if you chose.

Although research has found MRM to be generally safe and effective, like all surgical procedures it can have risks. They include:

  • Bleeding
  • Infection
  • Swelling of the arm
  • Pockets of fluid forming underneath the incision (called seromas)
  • Risks from general anesthesia

Some people have numbness in the upper arm after surgery. It’s caused by damage to small nerves in the area where the lymph nodes are taken out. There is a good chance that you’ll regain most of the feeling in your arm over time.

Lymph nodes that are removed will be sent to a lab to see whether the cancer has spread to them.

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After a Modified Radical Mastectomy

After your surgery, you’ll stay in the hospital for one or two nights. Thin plastic tubes will be placed in your breast area and attached to small suction devices to drain any fluid. You’ll need to keep these drains in for about a week. The hospital staff will show you how to care for them until your follow-up visit with the doctor.

Your doctor will prescribe medication for any pain you feel after surgery. After a week or two, you can usually treat your discomfort with over-the-counter pain relievers.

There’s a good chance that you’ll feel tired after your surgery. Try to take a break and rest during the 2 weeks following your surgery.

Depending on the size of your tumor and whether the cancer has spread to your lymph nodes, your doctor might recommend that you have radiation after your surgery. This helps kill any remaining cancer cells.

Keep in mind, not all women can have a modified radical mastectomy, and there are many surgical options for breast cancer. Your doctor will recommend an operation for you based on the size of the tumor, its stage (which tells how far it has spread), and its grade (how aggressive it is). Your age, overall health, and personal preferences will help you decide which surgery is right for you.

WebMD Medical Reference Reviewed by Sujana Movva, MD on June 28, 2015

Sources

SOURCES:

Manouras, A. Archives of Surgery, June 2008.

Mayo Clinic: "Modified Radical Mastectomy."

Breastcancer.org: "What is Mastectomy?"

Townsend, C. Sabiston Textbook of Surgery, Saunders Elsevier, 2007.

Brunicardi, F. Schwartz's Manual of Surgery, McGraw-Hill, 2006.

McPhee, S. Lange 2008 Current Medical Diagnosis & Treatment, McGraw-Hill Medical, 2008.

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