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A mastectomy is surgery to remove a breast. Sometimes other tissues near the breast are also removed. It is part of treatment for breast cancer. In some cases, a mastectomy is done to prevent cancer from occurring in women who have a high risk for breast cancer.
A mastectomy may be done as part of treatment for breast cancer.
Your doctor will likely advise you to have a mastectomy if:
The size of your breast may also help determine the type of mastectomy that is done.
In some cases, women with a high risk for breast cancer may want to have a mastectomy before cancer develops. This includes women with genes linked to breast cancer, such as the BRCA1 or BRCA2 gene. In these cases, a mastectomy is done to try to keep breast cancer from occurring.
There may be other reasons for your doctor to recommend a mastectomy.
There are several types of mastectomy procedures:
Some newer mastectomy methods may offer more surgery options. But more studies are needed to see if these methods work as well to fully remove breast cancer or stop from starting or coming back after treatment. Newer methods include:
You may worry about how your breast will look after a mastectomy. In most cases, breast reconstruction surgery can be done. This surgery rebuilds the breast so it is the size and shape of your other breast. Many women have breast reconstruction done at the same time as a mastectomy. Some wait and have it done as a second surgery later.
Talk with your doctor about your reconstructive surgery options. Other options after a mastectomy include wearing a breast form (breast prosthesis) or a special mastectomy bra.
All procedures have some risk. Some possible complications of mastectomy include:
A clear fluid (seroma) is often found in the breast after a mastectomy. If this bothers you, it can be drained in the surgeon’s office. If needed, it can then be treated with compression. Or you may get an injection that helps to harden the space in the breast to help keep fluid from collecting there.
You will likely have a scar at the mastectomy site. You may also have a pulling feeling near or under your arm after surgery.
Depression and feelings of loss of sexual identity may occur after a mastectomy.
It’s rare that breast reconstruction surgery causes complications. But problems may happen as you are healing. These problems may interfere with radiation or chemotherapy treatment.
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor before the surgery.
A mastectomy typically requires a hospital stay. Procedures may vary depending on your condition and your doctor's practices.
Generally, a mastectomy follows this process:
After the procedure, you will be taken to the recovery room and watched closely. Your recovery process will vary depending on the type of procedure done and the type of anesthesia you are given. Once your blood pressure, pulse, and breathing are stable and you are alert, you will be taken to your hospital room.
You will likely stay in the hospital for 1 to 3 days after your mastectomy. This will depend on the extent of your surgery and if you also had breast reconstruction done.
Radiation therapy or chemotherapy may be needed after a mastectomy. Your doctor will advise you about this depending on your particular situation.
Once you are home, keep the surgical area clean and dry. Your doctor will give you specific bathing instructions. Unless instructed otherwise, the narrow strips of tape across the incision can get wet during a shower. You may be directed to replace a wet dressing with a clean, dry one.
You will be instructed about how to take care of the drainage tube. This should be removed after about 2 weeks at the first follow-up exam.
The amount of pain you have will vary. It depends on the amount and location of tissue removed during surgery. Most soreness may last a few days. Take a pain reliever as advised by your doctor. Aspirin and some other pain medicines may increase your chance of bleeding. Be sure to take only recommended medicines.
If lymph node removal (dissection) was done with your mastectomy, your doctor may want you to do certain exercises. These can help limber up your shoulder and arm area, and help prevent swelling. Soreness after lymph node removal may cause you to keep your arm and shoulder very still. This can make your arm and shoulder stiff. But overdoing the exercises can also hurt you. So start the exercises slowly. Do them regularly, and progress a little each day. You may be advised to do these exercises even if you didn’t have lymph node removal.
You can often go back to your normal activities in a few weeks, based on your doctor’s recommendation. In the meantime, avoid doing anything strenuous. Don’t do things that involve using your arm too much, such as cleaning windows or vacuuming for a long time. Your doctor will tell you when you can start driving again and when you can go back to work.
If you have problems dealing with your recovery, your doctor may refer you to a volunteer agency or group for support.
Tell your doctor if you have any of the following:
Your doctor may give you other instructions, depending on your situation.
Removing lymph nodes may affect how lymphatic fluid drains from your arm, neck, and chest on the affected side. Problems with lymphatic drainage can cause swelling in your arm. You may also be at greater risk for infection from injury to your arm. And there is a higher risk for blood clots in your armpit veins after surgery to the area.
You will have to follow certain safety steps for the rest of your life after lymph node removal. This will help prevent problems in the affected arm. These safety steps include:
Before you agree to a test or procedure, make sure you know:
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