Types of Mastectomy to Treat Breast Cancer

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?

With this procedure, also called simple mastectomy, your doctor removes your entire breast, including the nipple. Your lymph nodes, the small glands that are part of your immune system, may sometimes be removed from your underarm..

You’re most likely to have a total mastectomy if the cancer has not spread beyond the breast, or if you’re having a preventative mastectomy to lower your risk of getting breast cancer.

What Is a Preventive Mastectomy?

Women who have a high risk of breast cancer may choose to have a preventive mastectomy, also called prophylactic 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.

Some women who've had breast cancer in one breast will decide to have a preventive mastectomy to remove the other breast. This can reduce the chance of cancer reoccurrence.

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.

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The surgery is often 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 typically 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.

WebMD Medical Reference Reviewed by Laura J. Martin, MD on October 22, 2017

Sources

SOURCES:

American Cancer Society: "Surgery for Breast Cancer."

National Comprehensive Cancer Network: "Breast Cancer: Treatment Guidelines for Patients."

Cancer Net: "Guide to Breast Cancer."

BreastCancer.org: "What is Mastectomy?"

John Hopkins Medicine: “Mastectomy.”

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