A mastectomy is a surgical surgery used mostly to cure or prevent breast cancer. It involves removing the whole breast. The extent of tissue and skin removed, as well as whether the nipple and areola are maintained, determine the type of mastectomy that is performed. Breast reconstruction, which uses implants or tissue from other regions of the body to restore the breast's form and appearance, might come after a mastectomy.
The main reason for having a mastectomy is to treat or prevent breast cancer. Mastectomy may be recommended if:
The breast cancer is large compared to the size of the breast, or there are multiple tumors in different areas of the breast.
The breast cancer has spread to the skin, chest wall, or lymph nodes under the arm.
The breast cancer has come back after previous treatment with lumpectomy and radiation therapy.
The person has a genetic mutation that increases the risk of developing breast cancer, such as BRCA1 or BRCA2.
The person prefers mastectomy over breast-conserving surgery (lumpectomy) for personal reasons.
The symptoms of breast cancer that may lead to a mastectomy include:
A lump or mass in the breast or underarm area that feels hard, irregular, or fixed.
Changes in the size, shape, or appearance of the breast or nipple, such as dimpling, puckering, inversion, or scaling.
Discharge, bleeding, or pain from the nipple.
Swelling, redness, or warmth in the breast or skin.
A rash or sore on the nipple or areola.
The diagnosis of breast cancer that may require a mastectomy involves:
A physical exam of the breast and lymph nodes by a doctor or nurse.
A mammogram, which is an X-ray of the breast that can detect abnormal masses or calcifications.
An ultrasound, which is a sound wave imaging of the breast that can distinguish between solid and fluid-filled lumps.
A biopsy, which is a procedure that removes a small sample of breast tissue and examines it under a microscope to look for cancer cells and determine their type and grade.
A blood test, which can check for the presence of genetic mutations that increase the risk of breast cancer, such as BRCA1 or BRCA2.
The treatment of breast cancer with mastectomy involves:
The whole breast—including the areola, nipple, and occasionally the lymph nodes beneath the arm—being removed. The extent of skin and tissue removal, as well as whether the areola and nipple are maintained, determine the kind of mastectomy. The primary varieties of mastectomies are:
Simple (or total) mastectomy, which removes the entire breast, including the nipple, areola, and skin.
Modified radical mastectomy, which removes the entire breast, including the nipple, areola, and skin, and also the lymph nodes under the arm.
Skin-sparing mastectomy, which removes the entire breast, including the nipple and areola, but leaves most of the skin intact.
Nipple-sparing mastectomy, which removes the entire breast, but leaves the nipple, areola, and skin intact.
Breast reconstruction, which uses implants or tissue from other regions of the body to restore the breast's form and appearance. Breast reconstruction can be performed either later (delayed reconstruction) or concurrently after mastectomy (immediate reconstruction). The person's preferences and availability, the breast's size and shape, and the kind of mastectomy all influence the type of reconstruction. The primary reconstructive types are:
Implant reconstruction, which uses a silicone or saline-filled device that is placed under the chest muscle or skin to create a new breast mound.
In order to generate a new breast mound, flap reconstruction involves attaching a portion of tissue from another area of the body, such as the back, thigh, or abdomen, to the chest. The tissue can be linked to a new blood supply (free flap) or have its own blood supply (pedicled flap).
Nipple and areola reconstruction, which creates a new nipple and areola using skin from another part of the body, such as the groin, ear, or opposite breast, or using a tattoo.
There is no sure way to prevent breast cancer, but there are some steps that can be taken to reduce the risk or detect it early, such as:
Having regular breast exams and mammograms, as recommended by a doctor or nurse, to check for any changes or abnormalities in the breast or lymph nodes.
Being aware of the signs and symptoms of breast cancer, and reporting any changes or concerns to a doctor or nurse as soon as possible.
Having a healthy lifestyle, which includes eating a balanced diet, maintaining a healthy weight, exercising regularly, limiting alcohol intake, and avoiding smoking.
Following a doctor's or nurse's recommendation to undergo preventative treatment or surgery if a patient has a high risk of getting breast cancer, such as a genetic mutation, a strong family history, or a prior history of breast cancer. Tamoxifen and raloxifene are examples of preventive medications that inhibit the effects of estrogen on breast tissue. Bilateral mastectomy, which eliminates both breasts, and bilateral salpingo-oophorectomy, which removes both ovaries and fallopian tubes, are examples of preventive surgery.
