What is a mastectomy?
May 20, 2021
Medically Reviewed | Last reviewed by an MD Anderson Cancer Center medical professional on May 20, 2021
Last updated Sept. 5, 2024
A mastectomy is one of the most well-known types of breast cancer treatment. MD Anderson breast surgeons perform more than 550 mastectomies each year. But not every breast cancer patient needs this surgery.
“At MD Anderson, our multidisciplinary care teams specialize in personalized care and will help determine what type of treatment is best for you and if that includes surgery, specifically a mastectomy,” says Susie Sun, M.D., a breast surgeon.
We spoke to Sun about which patients should undergo a mastectomy, what recovery from a mastectomy is like and which types of breast reconstruction are available to patients who choose to undergo a mastectomy.
What is a mastectomy?
A mastectomy is a breast cancer surgery in which the surgeon removes the tumor and the entire breast.
There are several types of mastectomies. These include:
- Total mastectomy: The surgeon removes the entire breast and most of the overlying skin.
- Partial mastectomy: This is also called a lumpectomy, a segmental masectomy, breast conserving surgery, or breast conservation surgery. In this procedure, the surgeon removes the tumor and surrounding breast tissue.
- Radical mastectomy: The surgeon removes the breast tissue and surrounding chest muscles. This was once the most common type of mastectomy, but it is rarely performed today.
- Modified radical mastectomy: The surgeon removes the breast tissue and lymph nodes under the arm to remove cancer and indicate how far the cancer has spread.
- Nipple-sparing mastectomy: The surgeon removes all of the breast tissue, but leaves the nipples and the areola.
- Skin-sparing mastectomy: The surgeon removes all of the breast tissue, including the nipple and areola, but leaves the skin.
- Double mastectomy: Also called a bilateral mastectomy, this is when the surgeon removes the tissue from both breasts. A double mastectomy is performed if there is cancer in both breasts or if the patient has a BRCA 1 or BRCA 2 genetic mutation, which raises the risk of cancer.
Who needs a mastectomy?
Because the mastectomy is so well-known, breast cancer patients often assume that’s the treatment they should have or will have to have. But well-established research going back to the 1970s shows that, together, patients who have a lumpectomy and radiation therapy have the same low risk of breast cancer recurrence as patients who have a mastectomy.
Mastectomies are best for patients who cannot withstand radiation. This includes patients who:
- had radiation therapy previously,
- have a recurrent cancer, or
- have soft-tissue disorders.
Mastectomies are also a good option if the patient is not a lumpectomy candidate based on the size or location of the breast cancer.
“When I meet with a patient, I like to give them all the options and discuss which one is safest for them,” Sun says. “Ultimately, I want the patients to choose what treatment is best for them.”
What are the risks of a mastectomy?
Like any surgery, a mastectomy has some risks. These include:
- breast pain
- swelling
- necrosis: If the patient has a nipple-sparing or skin-sparing mastectomy, there is some risk that the skin will not receive enough blood and need to be removed.
“Breast cancer surgery is most successful and you’re far less likely to experience any of these risks if you have an experienced surgeon who performs a large number of mastectomies,” Sun says.
What should patients expect during a mastectomy?
Before a mastectomy, patients receive general anesthesia. The surgery typically takes about two hours, but may take longer if the surgeon needs to remove any surrounding lymph nodes to determine whether the cancer has spread, or if the patient plans to undergo breast reconstruction.
Surgery at MD Anderson takes a little longer because both a pathologist and a radiologist review the removed breast tissue to determine if more tissue should be removed. As a result, MD Anderson has a higher clear margin rate. This means that fewer patients need an additional surgery after a mastectomy.
How long does it take to recover from a mastectomy?
Patients who do not undergo reconstruction typically leave the hospital the next day. Patients who have breast reconstruction using their own tissue and a mastectomy are typically in the hospital a little longer – about four to five days.
MD Anderson care teams use an Enhanced Recovery Program that helps alleviate pain. Most mastectomy patients only need prescription pain medication for a few days after they return home.
Patients who have additional reconstruction along with a mastectomy will need more time to recover, depending on which type of breast reconstruction they choose.
What types of breast reconstruction are available for patients who have had a mastectomy?
Breast cancer patients who have undergone a mastectomy have many options for breast reconstruction. At MD Anderson, our plastic surgeons will meet with you as you plan your mastectomy to discuss which options are best for you. Options include implant reconstruction or reconstruction using the patients’ own tissue. Both options may be done immediately or may be delayed.
“MD Anderson’s plastic surgeons only work with cancer patients. They know what unique challenges this group faces and how to give them the best outcomes,” Sun says. “From diagnosis to reconstruction, each part of MD Anderson’s multidisciplinary care teams work with our patients to find the type of treatment they’re most comfortable with.”
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A mastectomy is one of the most well-known types of breast cancer treatment. MD Anderson breast surgeons perform more than 1,000 mastectomies each year. But not every breast cancer patient needs this surgery.
“At MD Anderson, our multidisciplinary care teams specialize in personalized care and will help determine what type of treatment is best for you and if that includes surgery, specifically a mastectomy,” says Susie Sun, M.D., a breast surgeon.
We spoke to Sun about which patients should undergo a mastectomy, what recovery from a mastectomy is like and which types of breast reconstruction are available to patients who choose to undergo a mastectomy.
What is a mastectomy?
A mastectomy is a breast cancer surgery in which the surgeon removes the tumor and the entire breast.
There are several types of mastectomies. These include:
Total mastectomy: The surgeon removes the entire breast and most of the overlying skin.
Partial mastectomy: This is also called a lumpectomy. In this procedure, the surgeon removes the tumor and surrounding breast tissue.
Radical mastectomy: The surgeon removes the breast tissue and surrounding chest muscles. This was once the most common type of mastectomy, but it is rarely performed today.
Modified radical mastectomy: The surgeon removes the breast tissue and lymph nodes under the arm to remove cancer and indicate how far the cancer has spread.
Nipple-sparing mastectomy: The surgeon removes all of the breast tissue, but leaves the nipples and the areola.
Skin-sparing mastectomy: The surgeon removes all of the breast tissue, including the nipple and areola, but leaves the skin.
Double mastectomy: Also called a bilateral mastectomy, this is when the surgeon removes the tissue from both breasts. A double mastectomy is performed if there is cancer in both breasts or if the patient has a BRCA 1 or BRCA 2 genetic mutation, which raises the risk of cancer.
Who needs a mastectomy?
Because the mastectomy is so well-known, breast cancer patients often assume that’s the treatment they should have or will have to have. But well-established research going back to the 1970s shows that, together, patients who have a lumpectomy and radiation therapy have the same low risk of breast cancer recurrence as patients who have a mastectomy.
Mastectomies are best for patients who cannot withstand radiation. This includes patients who:
had radiation therapy previously,
have a recurrent cancer, or
have soft-tissue disorders.
Mastectomies are also a good option if the patient is not a lumpectomy candidate based on the size or location of the breast cancer.
“When I meet with a patient, I like to give them all the options and discuss which one is safest for them,” Sun says. “Ultimately, I want the patients to choose what treatment is best for them.”
What are the risks of a mastectomy?
A mastectomy is a safe surgery, but there are some risks. These include:
breast pain
swelling
necrosis: If the patient has a nipple-sparing or skin-sparing mastectomy, there is some risk that the skin will not receive enough blood and need to be removed.
“Breast cancer surgery is most successful and you’re far less likely to experience any of these risks if you have an experienced surgeon who performs a large number of mastectomies,” Sun says.
What should patients expect during a mastectomy?
Before a mastectomy, patients receive general anesthesia. The surgery typically takes about two hours, but may take longer if the surgeon needs to remove any surrounding lymph nodes to determine whether the cancer has spread, or if the patient plans to undergo breast reconstruction.
Surgery at MD Anderson takes a little longer because both a pathologist and a radiologist review the removed breast tissue to determine if more tissue should be removed. As a result, MD Anderson has a higher clear margin rate. This means that fewer patients need an additional surgery after a mastectomy.
How long does it take to recover from a mastectomy?
Patients who do not undergo reconstruction typically leave the hospital the next day. Patients who have breast reconstruction using their own tissue and a mastectomy are typically in the hospital a little longer – about four to five days.
MD Anderson care teams use an Enhanced Recovery Program that helps alleviate pain. Most mastectomy patients only need prescription pain medication for a few days after they return home.
Patients who have additional reconstruction along with a mastectomy will need more time to recover, depending on which type of breast reconstruction they choose.
What types of breast reconstruction are available for patients who have had a mastectomy?
Breast cancer patients who have undergone a mastectomy have many options for breast reconstruction. At MD Anderson, our plastic surgeons will meet with you as you plan your mastectomy to discuss which options are best for you. Options include implant reconstruction or reconstruction using the patients’ own tissue. Both options may be done immediately or may be delayed.
“MD Anderson’s plastic surgeons only work with cancer patients. They know what unique challenges this group faces and how to give them the best outcomes,” Sun says. “From diagnosis to reconstruction, each part of MD Anderson’s multidisciplinary care teams work with our patients to find the type of treatment they’re most comfortable with.”
When I meet with a patient, I like to give them all the options and discuss which one is safest for them.
Susie Sun, M.D.
Physician