FAQ: Mastectomy

Q: What is a mastectomy?

A: Mastectomy is the surgical removal of one or both breasts to treat or reduce the risk of breast cancer.

Q: Who needs a mastectomy?

A: Although lumpectomy is an option for many people with breast cancer, mastectomy is usually recommended for individuals who:

• have a tumor that is 2" or larger or large in relation to the overall size of their breast.

• have multiple tumors in different areas of the breast.

• have widespread ductal cancer in situ (precancerous cells) throughout the breast.

• have cancer cells remaining in the breast after lumptectomy.

• have inflammatory breast cancer.

• have Paget's disease of the nipple.

• are eligible for a lumpectomy, but cannot have (or prefer not to have) the accompanying radiation therapy.

• are diagnosed with breast cancer during pregnancy.

• have an inherited gene mutation or a family history that significantly raises breast cancer risk.

Q: Is there more than one kind of mastectomy?

A: Mastectomy can be done in different ways. Discuss your options with your surgeon: ask which mastectomy procedure is recommended and why, which will accommodate your preferences for going flat or breast reconstruction, and what to expect. Ask to see a few of the surgeon's mastectomy patient photos.

Q: Can you keep your nipples?

A: Yes, if your tumor is a safe distance from the nipple (if your mastectomy is performed to treat breast cancer) and doesn't include any cancer cells. Preserving blood supply to the nipple is critical for nipple health. A nipple that doesn't get adequate blood may flatten, look different, lose some or all sensation, or not survive. Be sure to discuss this option during your consultation, since not all surgeons perform nipple-sparing flat closures. Ask about your surgeon's experience and success rate with nipple-sparing mastectomy

Q: Do lymph nodes need to be removed?

A: One or more underarm lymph nodes are removed when invasive breast cancer is diagnosed. Other swollen or questionable nodes will also be removed. Lymph node removal may be skipped by adults over age 70 who have small, early-stage tumors that are hormone receptor-positive.

Q: Does mastectomy require an overnight hospital stay?

A: Some people who have a simple mastectomy (without lymph node removal) and no reconstruction go home the same day. People who have immediate reconstruction spend 1 to 3 days in the hospital; 3 to 5 days are typically needed after autologous tissue reconstruction.