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Mastectomy
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Mastectomy

(Breast Surgery; Surgery for Breast Cancer; Surgery to Remove a Breast)

En Español (Spanish Version)

Click here to view an animated version of this procedure.

Definition

A number of different mastectomy procedures exist, including:

  • Partial mastectomy or lumpectomy—the tumor and a small margin of surrounding breast tissue is removed
  • Simple mastectomy—the entire breast is removed
  • Modified radical mastectomy—entire breast and some axillary lymph nodes (lymph nodes near the breast) are removed, but chest muscles are left in place
  • Radical mastectomy—entire breast, axillary lymph nodes, and chest muscle are removed (rarely done)

Mastectomy

mastectomy

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • Breast
  • Axillary lymph nodes
  • Chest wall muscle (rare)

Reasons for Procedure

  • To treat breast cancer
  • To prevent breast cancer if you have a family history of the disease (occasionally done)
  • To treat severe side effects from previous treatment for breast cancer (rarely done)

Risk Factors for Complications during the Procedure

  • Obesity
  • Poor nutrition
  • Smoking
  • Recent or chronic illness
  • Use of certain medications or dietary supplements

What to Expect

Prior to Procedure

Your doctor will likely do the following:

In the days leading up to your procedure:

  • Discuss any medications or dietary supplements you are taking with your surgeon.
  • Arrange for a ride home.
  • Unless your doctor tells you otherwise, do not eat or drink anything for 8-12 hours prior to surgery.

Description of the Procedure

An oval-shaped incision is made in the breast. The breast tissue, including the nipple and areola, are removed by cutting the tissue off of the underlying muscle. Nearby lymph nodes (toward the underarm) may also be removed. A tube may be inserted to drain fluid. This tube will be removed in the surgeon's office 1-2 days later. The area is closed with stitches.

After Procedure

Removed tissue is examined by a pathologist. Chemotherapy and/or radiation may be needed if the cancer has spread.

How Long Will It Take?

1-3 hours

Will It Hurt?

Anesthesia prevents pain during the procedure.

Possible Complications

  • Hematoma (accumulation of blood in the wound)
  • Seroma (accumulation of clear fluid in the wound)
  • Infection
  • Swelling of the arm caused by accumulation of fluid in lymph nodes (lymphedema)
  • Limited arm and shoulder movement
  • Numbness of skin on upper arm
  • Pain after the procedure (burning, stabbing pain where breast was removed), may be due to nerve damage

Average Hospital Stay

1-2 days

Postoperative Care

Once home, follow your doctor's instructions , such as:

  • Keep the surgical area clean and dry.
  • You will have a bandage over the site. You may also have tubes to drain blood and fluids that collect during the healing process. Empty the drains, measure the fluid, and report any problems to your doctor.
  • Avoid vigorous activity for about six weeks.
  • Follow your doctor's advice for physical therapy. You may be instructed to do shoulder and arm exercises.

If you've had lymph nodes removed, your arm is at risk of fluid accumulation and infection. Take these special precautions:

  • Do not have blood pressure taken, blood drawn, or shots given in that arm.
  • Wear gloves to do dishes, household scrubbing, and yard work.
  • Do not wear anything tight on that arm, including elastic in sleeves.
  • Do not carry anything heavy in that arm.
  • Use moisturizer on that arm.
  • Use an electric shaver to shave your armpits.
  • Do not get a sunburn .

Outcome

The average time for recovery is about six weeks.

There is usually little pain after a lumpectomy. But, there may be numbness and a pinching or pulling feeling in the underarm area. You may be prescribed pain medication or antibiotics.

You'll see your doctor within 7-14 days after the surgery. Your doctor will discuss the results and further treatment. About a month after surgery, you can begin wearing a light-weight prosthetic breast. You can be fitted for a more permanent one when your surgeon says your incision is healed. If you want breast reconstruction surgery, talk to your surgeon.

Call Your Doctor If Any of the Following Occurs

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain, or severe nausea or vomiting
  • Redness, warmth, swelling, stiffness, or hardness in the arm or hand on the side of the body where the lymph nodes were removed
  • New, unexplained symptoms
  • Lumps or skin changes in remaining tissue on mastectomy side
  • Lumps, skin changes, or nipple drainage in remaining breast

RESOURCES:

American Cancer Society
http://www.cancer.org/

Breastcancer.org
http://www.breastcancer.org/

CANADIAN RESOURCES:

Canadian Breast Cancer Foundation
http://www.cbcf.org/

Canadian Cancer Society
http://www.cancer.ca/

References:

Axillary lymph nodes. Breastcancer.org website. Available at: http://www.breastcancer.org/pictures/breast_anatomy/axillary_lymph_nodes.jsp . Updated May 2008. Accessed July 22, 2008.

Surgery for breast cancer. American Cancer Society. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_5.asp?sitearea= . Updated September 2007. Accessed July 23, 2008.

Treatments and side effects. Breastcancer.org website. Available at: http://www.breastcancer.org/treatment/ . Updated July 2008. Accessed July 22, 2008.



Last reviewed March 2008 by Igor Puzanov, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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