A mastectomy is the surgical removal of the entire breast, including the tumor and all surrounding breast tissue. Mastectomy may be more suitable for women who have a larger tumor size relative to breast size or when cancer is multicentric (multiple tumor sites within the breast). Mastectomy is also often appropriate when a patient has tested positive for a mutation in the BRCA 1 or 2 gene.
There are different types of mastectomy, which include:
- Total (simple) mastectomy–removal of cancer and the entire breast. This is the most common type of mastectomy.
- Modified radical mastectomy–removal of cancer along with the entire breast and all axillary lymph nodes.
- Radical mastectomy–removal of cancer along with the entire breast and lymph nodes, as well as the chest wall muscles under the breast. Today, this type of mastectomy is rarely performed, unless the cancer has spread to the chest muscles.
- Skin and nipple-sparing mastectomy–this is a total mastectomy. It removes the tumor and most of the surrounding breast tissue but it spares the skin, nipple and areola. Immediate reconstruction is performed.
During the last 10 years, there has been an increase in women requesting removal of both breasts (bilateral mastectomy). The advancements in surgical techniques and genetic testing have caused the increase. Surgeons today can offer reconstructive surgery to patients wanting to remove their entire breast(s), and can offer skin-sparing and nipple-sparing techniques.
We understand that this decision is an emotional and stressful one, and having full knowledge and even a second opinion by a reputable physician (or group of physicians) may help you determine the best option. It is essential for you to be well informed and confident in your decision.
We encourage you to discuss the specifics of a mastectomy with your surgeon and other members of your care team.