Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

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Definition

A mastectomy is a surgery done to remove breast tissue. A number of different mastectomy procedures exist, including:

  • Partial mastectomy or lumpectomy—a tumor and a small margin of surrounding breast tissue is removed
  • Simple mastectomy—the entire breast is removed
  • Modified radical mastectomy—entire breast and some lymph nodes in the armpit are removed, but chest muscles are left in place
  • Radical mastectomy—entire breast, lymph nodes, and chest muscle are removed (rarely done)

Mastectomy

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Reasons for Procedure

A mastectomy is done:

  • To treat breast cancer
  • To prevent breast cancer if you have a family history of the disease and are at very high risk for breast cancer (occasionally done)
  • To treat severe side effects from previous treatment for breast cancer (rarely done)

Possible Complications

Complications are rare, but no procedure is completely free of risk. If you are planning to have a mastectomy, your doctor will review a list of possible complications, which may include:

Some factors that may increase the risk of complications include:

  • Obesity
  • Poor nutrition
  • Smoking
  • Recent or chronic illness
  • Use of certain medicines or dietary supplements

Be sure to discuss these risks with your doctor before the surgery.

What to Expect

Your doctor may do the following:

  • Physical exam
  • Mammogram—a test that uses low-dose x-rays to make a picture of breast tissue
  • Fine needle biopsy of the breast—a thin, hollow needle is used to remove a small tissue sample from the breast
  • Blood tests

Leading up to the surgery:

  • Talk to your doctor about your medicines and supplements. You may be asked to stop taking some medicines up to one week before the procedure like:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
  • Arrange for a ride home. Ask someone to help you at home.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

General anesthesia will be used in most cases. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

The doctor will make an oval-shaped incision in the breast. The breast tissue, including the nipple and areola, will be removed. This will be done by cutting the tissue off of the underlying muscle. Nearby lymph nodes (toward the underarm) may also be removed. The doctor will then insert a tube to drain blood and fluids. Lastly, the area will be closed with stitches.

1-3 hours

Anesthesia will prevent pain during the procedure. You may have pain while recovering. You may also have numbness and a pinching or pulling feeling in the underarm area. Your doctor will give you pain medicine to help control this pain. If you are having a small area removed, you may not have much pain.

1-3 days

  • If you had cancer and it has spread, chemotherapy and/or radiation may be needed.
  • The drainage tubes may be removed in 1-2 days.
  • Managing pain and nausea—You might require anti-nausea and pain medicines. You may be nauseated for a few hours after surgery and may not be able to eat normally. Therefore, you may continue to receive fluids and sugar through an IV. For several days after surgery, you may need to eat a lighter, blander diet than usual.
  • Preventing blood clots—You may be given special compression stockings to wear after surgery. These help to decrease the possibility of blood clots forming in your legs.
  • Improving lung function—You may be asked to use an incentive spirometer. This is a device that helps you breathe deeply. It is important to breathe deeply and cough frequently to improve lung function after general anesthesia.

When you return home, do the following to help ensure a smooth recovery:

Recovery will take about six weeks. You will see your doctor within 7-14 days after the surgery. Your doctor will discuss the results and further treatment. About a month after surgery, you can begin wearing a light-weight prosthetic breast. You can be fitted for a more permanent one when the incision area has healed. If you want breast reconstruction surgery, talk to your doctor.

Call Your Doctor

After you leave the hospital, contact your doctor if any of the following occurs:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain
  • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Redness, warmth, swelling, stiffness, or hardness in the arm or hand on the side of the body where the lymph nodes were removed
  • Swelling and/or pain in your legs
  • New, unexplained symptoms
  • Lumps or skin changes in remaining tissue on mastectomy side
  • Lumps, skin changes, or nipple drainage in remaining breast
  • Depression

In case of an emergency, call for medical help right away.