Mastectomy is the most common treatment for men with breast cancer. Just like mastectomy in women, this surgery is done to remove a breast affected by cancer.
Because men have so little breast tissue, doctors usually remove the whole breast. Your doctor may also remove some nearby lymph nodes. Those are tiny glands that are part of your body's immune system. They also might recommend that you have the other breast removed to keep you from getting cancer there as well.
The earlier you're treated, the better your chances of being cured. If you have a mastectomy, your doctor can do another surgery afterward to help afterward to help reconstruct the area.
Deciding on Surgery
Your doctor's recommendation will be based on the stage of your cancer and your overall health. The stage refers to how big it is and how far it's spread. Discuss all your options with your doctor and find out about the benefits and risks of surgery and other treatments before you make a decision.
Before the Surgery
You'll meet with your surgeon to find out what to expect. Let them know all the medicines and supplements you take, especially if you're on aspirin or blood thinners. You might have to stop taking certain medicines a week or two before the procedure.
During the Surgery
A nurse will put a needle that connects to a tube into a vein in your arm. This is called an IV. You'll get medicine through the IV to make you sleep through the surgery. That will keep you from feeling any pain.
There are different kinds of mastectomy:
- Simple or total mastectomy takes off the whole breast, including your nipple.
- Modified radical mastectomy removes the whole breast and nipple and many of the lymph nodes under your arm.
- Radical mastectomy takes off the whole breast, lymph nodes, and the chest wall muscles under the breast.
- Partial mastectomy or lumpectomy removes just the tumor and some of the tissue around it. This is also called breast-conserving surgery. It's not used as often in men, because men have very little breast tissue.
To see if your cancer has spread, you might have one of these during your surgery or afterward:
- Sentinel lymph node biopsy (SLNB): Your doctor takes only a few lymph nodes from where the cancer is most likely to have spread. To find them, they put a radioactive substance or a blue dye into the area around the tumor. Then, a special device helps them find radioactivity in the nodes or nodes that have turned blue. A specialist will look at them under a microscope. If there are signs of cancer, your surgeon may do an ALND.
- Axillary lymph node dissection (ALND): Your doctor takes 10 to 40 lymph nodes from under your arm. These are checked under a microscope to see if there are signs of cancer.
A mastectomy with lymph node biopsy will take about 2 to 3 hours.
After Your Surgery
Once your surgery is done, you'll wake up from the anesthesia in a recovery room. If you don't have any issues, you'll go home later the same day or the next day.
You'll have a bandage around your chest. Plastic or rubber tubes will drain fluid from your breast area or underarm. Your medical team will show you how to care for and empty the drains and measure the fluid that comes out. They'll probably need to stay in place for 1 to 2 weeks after your surgery.
After the mastectomy, your doctor might recommend treatments to kill off any cancer cells left behind. These can include:
- Radiation: High-energy beams are targeted at the harmful cells.
- Chemotherapy: Strong drugs are used to kill the cells.
- Hormone therapy (depending on the type of cancer).
Men usually don't get reconstructive surgery with implants. That's because they don't help with the shape of a man's chest. But your doctor can make the affected breast look more natural and reconstruct your nipple.
Risks
Mastectomy is safe, but any surgery has risks. Possible side effects include:
- Pain
- Swelling
- Bleeding
- Infection
- Change in the look of your chest
- Swelling of your arm, called lymphedema (caused by taking out lymph nodes)
- Trouble moving your arm and shoulder
- Buildup of blood in the wound, called hematoma
- Buildup of fluid in the wound, called seroma
