Breast cancer is the second most common type of cancer among American women, and it occurs when the cells in the breast start to grow out of control. The malignant disease can affect either men or women, but only 1 percent of its patients are men. Breast cancer symptoms include a new breast lump or mass, swelling of all or part of a breast, skin irritation or dimpling, breast or nipple pain, nipple retraction, a nipple discharge other than breast milk, and redness, scaliness, or thickening of the nipple or breast skin.

Treatment options for patients with breast cancer depend both on a patient’s and the disease’s characteristics. Local treatment includes surgery and radiation therapy, and it is meant to attack the tumor without harming the rest of the body. Systemic treatments, like chemotherapy, hormone therapy, targeted therapy, and bone-directed therapy, use drugs that are able to kill cancer cells anywhere in the body. Breast-conversing surgery and mastectomy are the two most common surgical procedures for patients with breast cancer.

Different Mastectomy Procedures

Mastectomy is a surgery designed for the removal of all breast tissue, from the breast, nipple, and areola to the sentinel lymph node or nodes. It is usually a breast cancer treatment, but it can also be used to prevent the disease in people with a high probability of developing it. Mastectomy is an umbrella term, however, and there are differences among the procedures that comprise the surgical category. During a total or simple mastectomy, the whole breast and sometimes the lymph nodes are removed, while a modified radical mastectomy  consists of the removal of the breast and many lymph nodes under the arm, while a radical mastectomy also includes the removal of the lining of the chest muscles, which can be helpful when cancer has metastasized to nearby muscles although the procedure is now less common than a modified radical mastectomy. In addition, there is also skin-sparing mastectomy, during which the breast skin is left, and nipple-sparing (subcutaneous) mastectomy, which spares the skin, nipple, and areola.

A mastectomy is particularly indicated for patients with multiple or large areas of ductal carcinoma in situ or non-invasive breast cancer, according to BreastCancer.org, although a lumpectomy (one form of which is known as a partial mastectomy) is more common for this cancer, and for some stage I and stage II (early stage) breast cancers. A mastectomy is usually indicated for stage III (locally advanced) breast cancer in combination with chemotherapy, and for inflammatory breast cancer with chemotherapy, Paget’s disease of the breast, or locally recurrent breast cancer. Before the mastectomy, the surgeon and anesthesiologist will explain the procedure, and the patient is asleep under general anesthesia throughout it. Without reconstruction, the surgery usually takes between one and three hours, depending on factors particular to a procedure. A double mastectomy takes more time and requires a longer recovery. Regardless of the type of surgery, after the mastectomy, the breast tissue and lymph nodes are sent to a lab for analysis.

Benefits and Risks of a Mastectomy

The majority of patients may be able to choose between a breast-conserving surgery or a mastectomy, which can be a difficult decision. Both surgeries are effective, and a mastectomy is known to reduce the risk of cancer recurrence to between 1 percent and 3 percent. However, women may need radiation therapy and/or chemotherapy after the surgery. There are also risks associated with a mastectomy, such as bleeding, infection, pain, swelling (lymphedema) in the arm, formation of hard scar tissue at the surgical site, shoulder pain and stiffness, numbness — particularly under the arm — from lymph node removal, and buildup of blood in the surgical site (hematoma).

“A major disadvantage is that a mastectomy is permanent — you cannot replace the natural breast. Even with modern plastic surgical techniques, the breast and nipple lose sensation (become numb) after mastectomy,” Amber Bauer, from the American Society of Clinical Oncology (ASCO), said in an  ASCO article. “Another big disadvantage is that we know the more surgery that is performed, the higher the complication rate. Mastectomy with reconstruction has been associated with a 30% to 50% complication rate, including infection, poor healing, unplanned return to the operating room, implant problems, and more.”

Note: Breast cancer News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.