Mastectomy Breast Surgery: Types & What to Expect

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Mastectomy Breast Surgery

Learning you may need a mastectomy to treat your breast cancer can be tough emotionally. Although it’s natural to feel overwhelmed, remember that mastectomies are lifesaving. At Mercy, we provide the expertise and support you need for the journey ahead. And your breast cancer Nurse Navigator will guide you every step of the way.

What is a Mastectomy?

Mastectomy is the surgical removal of a breast. It’s a treatment option for many types of breast cancers, including DCIS (noninvasive), stages I and II (early-stage), stage III (locally advanced), inflammatory and locally recurrent cancers. In some cases, preventive (prophylactic) mastectomy is performed for people with a high risk of developing breast cancer in the future.

What are the Types of Mastectomy?

Mercy surgeons perform several different types of mastectomy. Each type uses specific techniques and removes different breast tissues. Your Mercy surgeon personalizes your treatment from among these options, helping you decide on the best approach for your unique situation.

Simple (Total) Mastectomy

In this procedure, the entire breast is removed, including the nipple, areola and excess skin to have a smooth surface across the chest wall. Lymph nodes may be removed if they’re located within the tissue taken. Muscles beneath the breast aren’t removed.

Double (Bilateral) Mastectomy

Removing both breasts is called a double (bilateral) mastectomy. It may be done as part of a breast cancer treatment plan or as a preventive measure for people with high breast cancer risk.

Skin-Sparing Mastectomy

This procedure leaves most of the skin over the breast intact. The breast tissue, areola and nipple are removed. It results in less scar tissue and can make reconstruction more natural-looking. But it’s not typically used for large tumors or those close to the skin surface.

Nipple-Sparing Mastectomy

Your surgeon removes the breast tissue but leaves your skin and nipple intact, checking them first for cancer cells. This procedure works best for small, early-stage cancers and preventive mastectomies.

Modified Radical Mastectomy

Similar to simple mastectomy, this procedure removes the entire breast, including the skin, tissue, areola and nipple. The lymph nodes under your arm are also removed (axillary lymph node dissection).

Radical Mastectomy

This is the most extensive mastectomy surgery. Your surgeon removes the entire breast, muscles under the breast and lymph nodes under your arm. It’s rarely performed unless large tumors grow into the chest wall.

Preventive (Prophylactic) Mastectomy

Removing both breasts to reduce high-risk breast cancer is called preventive (prophylactic) mastectomy. Most women who choose this procedure carry the BRCA1 or BRCA2 gene mutation or have other factors that greatly increase their breast cancer risk.

If your breast cancer was caught early, you may be able to choose between mastectomy and lumpectomy. Your breast surgeon will let you know if it’s an option and help you make an informed choice.

What to Expect After a Mastectomy

Your Mercy care team makes sure you understand what to expect before, during and after mastectomy surgery. We also support you in making treatment decisions. For example:

After mastectomy, you may choose to rebuild your breast(s) with breast reconstruction surgery. Wearing a breast prosthesis is another option, or you may feel comfortable with your new appearance after mastectomy.
If you’re considering breast reconstruction, you’ll meet with a Mercy plastic surgeon to discuss options, techniques and timing. Ask your Mercy treatment team if your breast reconstruction can be done at the time of your mastectomy. You may need (or choose) to schedule it separately.
Some patients need extra cancer treatments after mastectomy. These may include hormone therapy, chemotherapy or radiation therapy. Your Mercy doctor will help you understand what to expect from these treatments.

Coming to terms with your mastectomy can be difficult. But Mercy provides the care and support you need to heal and thrive.

Mastectomy Recovery

After your mastectomy, you’ll be moved to the recovery room. Your vital signs will be monitored to make sure you’re stable after surgery.

Hospital stay after a mastectomy is typically an overnight stay —longer if you also had breast reconstruction.

Your Mercy surgeon will give you instructions for recovering at home. These may include:

Managing pain – Your surgeon will talk with you about prescription pain medication and how often to take it.
Caring for the bandage (dressing) – You’ll learn how to care for the mastectomy bandage before your first follow-up visit with your doctor.
Caring for surgical drains – You may have drains in your breast or armpit. Sometimes they’re removed before you go home, or they may stay in until your first follow-up visit. If you’ll have drains at home, your caregivers will explain how to empty the detachable bulb as needed.
Removal of stitches or staples (if needed) – Some stitches are absorbable and don’t need to be removed. Surgical staples are usually removed at your first follow-up visit.

Spotting signs of infection – Your caregivers will explain what to look for and when to call your doctor. Always let your doctor know if you have fever or notice changes at the surgical site.
Exercising your arm and shoulder – You may be shown exercises you can do to prevent stiffness. Some exercises may need to be avoided until drains are removed.
Recognizing signs of lymphedema – If you had lymph nodes removed, fluid can build up, causing swelling, pain and sometimes infection.
Wearing a prosthesis or sports bra – You’ll need time to recover first, especially if you had breast reconstruction. Your care team will tell you how long to wait.

As nerves regrow in the months after surgery, you might feel discomfort, itching or pressure, or be sensitive to touch. Acetaminophen and ibuprofen can help, and the symptoms may go away on their own.

It’s normal to experience fatigue after surgery, so be sure to get plenty of rest. And share any concerns about your recovery with your Mercy doctor.

At Mercy, we offer comprehensive services to diagnose and treat a full range of conditions, including: