What is Mastectomy? Purpose, Procedure & Recovery

A mastectomy is a surgical procedure where part or all of your breast tissue is removed. This surgery is most commonly performed to treat or prevent breast cancer, though it may also be done for other medical conditions affecting breast tissue.

The decision to have a mastectomy can feel overwhelming, but understanding what the procedure involves can help you feel more prepared and confident about your care. Your medical team will work closely with you to determine the best approach for your specific situation.

What is mastectomy?

Mastectomy is the surgical removal of breast tissue to treat or prevent cancer. The procedure can range from removing just the tumor and surrounding tissue to removing the entire breast, depending on your specific medical needs.

There are several types of mastectomy procedures. A lumpectomy removes only the tumor and a small amount of surrounding tissue. A partial mastectomy removes the tumor along with a larger portion of breast tissue. A simple or total mastectomy removes the entire breast but leaves the chest muscles intact.

A modified radical mastectomy removes the entire breast plus some lymph nodes under the arm. In rare cases, a radical mastectomy may be needed, which removes the breast, chest muscles, and lymph nodes. Your surgeon will recommend the type that best addresses your specific condition while preserving as much healthy tissue as possible.

Why is mastectomy done?

Mastectomy is primarily performed to treat breast cancer or reduce the risk of developing it. Your doctor may recommend this surgery when other treatments aren't suitable or when you have a high genetic risk of breast cancer.

The most common reason for mastectomy is to remove cancerous tissue that cannot be adequately treated with less extensive surgery. This might happen when the tumor is large relative to your breast size, when there are multiple tumors, or when cancer has spread to nearby tissues.

Some people choose preventive mastectomy if they carry genetic mutations like BRCA1 or BRCA2 that significantly increase cancer risk. Other medical conditions that might require mastectomy include severe infections that don't respond to antibiotics or extensive non-cancerous growths that cause significant symptoms.

Your medical team will carefully evaluate your individual situation, considering factors like tumor characteristics, your overall health, and your personal preferences when recommending treatment options.

What is the procedure for mastectomy?

The mastectomy procedure typically takes two to three hours and is performed under general anesthesia. Your surgeon will make an incision across your breast and carefully remove the planned amount of tissue.

Before surgery begins, you'll meet with your anesthesia team and surgical staff. They'll review your medical history and answer any last-minute questions. An IV line will be placed to deliver medications and fluids during the procedure.

During the surgery, your surgeon follows a carefully planned approach based on your specific needs. They'll remove the designated breast tissue while preserving important structures like blood vessels and nerves when possible. If lymph nodes need to be removed, this is typically done through the same incision or a separate small incision under your arm.

After removing the tissue, your surgeon will place drainage tubes to prevent fluid buildup and close the incision with sutures or surgical staples. The removed tissue is sent to a laboratory for detailed examination, which helps guide any additional treatment decisions.

How to prepare for your mastectomy?

Preparing for mastectomy involves both physical and emotional preparation. Your medical team will provide specific instructions, but general preparation helps ensure the smoothest possible experience.

In the weeks before surgery, you'll likely have pre-operative appointments and tests. These might include blood work, imaging studies, and meetings with different members of your care team. You'll receive detailed instructions about eating, drinking, and medications before surgery.

Physical preparation includes arranging help at home for the first few days after surgery. You'll need assistance with daily activities like cooking, cleaning, and lifting anything heavier than a few pounds. Setting up a comfortable recovery space with easy access to necessities can make your healing more comfortable.

Emotional preparation is equally important. Many people find it helpful to speak with counselors, support groups, or others who have had similar experiences. Don't hesitate to ask your medical team about resources for emotional support throughout this process.

How does mastectomy recovery work?

Recovery from mastectomy typically takes several weeks to a few months, depending on the extent of your surgery and your individual healing process. Most people start feeling significantly better within the first two weeks.

Immediately after surgery, you'll spend time in a recovery area where medical staff monitor your vital signs and pain levels. You might stay in the hospital for one to three days, depending on your procedure type and how you're feeling.

During the first week at home, rest is your primary job. You'll have drainage tubes that collect fluid from the surgical site, and your medical team will teach you how to care for these. Pain medication helps manage discomfort, and gentle arm movements prevent stiffness.

Over the following weeks, you'll gradually increase your activity level. Most people can return to desk work within two to three weeks, though physical jobs may require more time. Your surgeon will let you know when it's safe to resume normal activities like driving, exercising, and lifting.

What are the risk factors for needing mastectomy?

Several factors can increase the likelihood that you might need a mastectomy. Understanding these risk factors helps you and your medical team make informed decisions about screening and prevention.

The strongest risk factors are genetic mutations, particularly BRCA1 and BRCA2 genes, which significantly increase breast cancer risk. A strong family history of breast or ovarian cancer, especially in close relatives diagnosed at young ages, also raises your risk.

Previous breast cancer or certain non-cancerous breast conditions can increase the likelihood of needing surgery in the future. Age is another factor, as breast cancer risk generally increases with time, though it can occur at any age.

Lifestyle factors that may influence risk include hormone exposure through birth control or hormone replacement therapy, alcohol consumption, and obesity. However, having risk factors doesn't mean you'll definitely develop cancer or need surgery. Regular screening and preventive care remain your best tools for early detection and treatment.

What are the possible complications of mastectomy?

Like any surgery, mastectomy carries some risks, though serious complications are relatively uncommon. Your surgical team takes many precautions to minimize these risks and will discuss them thoroughly with you beforehand.

Common short-term issues include pain, swelling, and bruising around the surgical site. Some people experience temporary numbness or tingling in the chest, arm, or shoulder area as nerves heal. Infection at the incision site can occur but is usually treatable with antibiotics.

Less common but more serious complications might include excessive bleeding, blood clots, or problems with wound healing. If lymph nodes are removed, there's a risk of developing lymphedema, which causes swelling in the arm or hand due to fluid buildup.

Very rare complications include damage to nearby structures like blood vessels or nerves, severe allergic reactions to anesthesia, or complications related to underlying health conditions. Your medical team monitors you carefully to catch and address any issues quickly.

When should I see a doctor about mastectomy concerns?

You should contact your medical team immediately if you experience signs of infection or other serious complications after surgery. Don't hesitate to reach out with any concerns during your recovery period.

Call your doctor right away if you develop fever, increasing redness or warmth around your incision, drainage that becomes thick, yellow, or foul-smelling, or if your pain suddenly worsens despite medication. These could indicate infection or other complications that need prompt attention.

Other concerning symptoms include excessive swelling in your arm or hand, severe nausea or vomiting that prevents you from keeping fluids down, chest pain or difficulty breathing, or signs of blood clots like leg swelling or pain.

For routine follow-up care, keep all scheduled appointments even if you're feeling well. These visits allow your medical team to monitor your healing, remove drainage tubes when appropriate, and discuss any additional treatments you might need.