Mastectomy

Mastectomy—surgical removal of breast tissue—is performed to treat breast cancer or to reduce an individual's unusually high risk of developing the disease.

  • unilateral mastectomy removes one breast.

  • bilateral mastectomy removes both breasts.

  • contralateral mastectomy removes a healthy breast when the opposite breast is removed to treat or prevent cancer.

  • prophylactic (preventive) mastectomy removes both healthy breasts to reduce the high risk of breast cancer.

​Mastectomy to treat breast cancer

If you're being treated for breast cancer, you may have a choice between lumpectomy and mastectomy. Lumpectomy removes the tumor and some surrounding tissue while preserving the remainder of the breast. Mastectomy removes the entire breast, including breast tissue, some skin, and may or may not include the nipple and areola.

​Mastectomy is usually recommended when:

  • tumors are found in multiple quadrants of the breast.

  • a breast tumor is large or disproportionately large compared
    to your breast volume.

  • it isn't possible to remove all of the cancerous tissue with a lumpectomy.

  • cancer has advanced beyond the breast.

  • cancer develops or returns in a breast that has already been radiated.

  • you are unable to have radiation therapy.

  • cancer is found during pregnancy.

  • you have an inherited gene mutation or a strong family history
    that increases your risk of a new or recurring cancer in the
    breast being treated.

Other factors and personal preferences may also influence whether you have a mastectomy.

Mastectomy to reduce breast cancer risk

The risk for developing breast cancer (and other cancers) can be unusually high for individuals who have a strong family history of breast cancer or an inherited mutation in a BRCA, CHEK2, PTEN or other gene linked to breast cancer.

Prophylactic (preventive) bilateral mastectomy removes both healthy breasts to reduce a person's high risk of breast cancer. It is the most effective method of addressing a predisposition to the disease: remove the breast tissue, and you remove most of the risk. In previvors (people who have a high hereditary risk of cancer but have not been diagnosed with cancer), preventive mastectomy is estimated to reduce breast cancer up to 90 to 95%, depending on an individual's personal risk factors. (A small risk remains because it may not be possible to eliminate all breast tissue.)

Preventive mastectomy is irreversible; it is not right for everyone. Most women who choose preventive mastectomy and want to have their breasts reconstructed are candidates for nipple-sparing mastectomy; this results in a reconstructed breast with your own nipple and no visible mastectomy scars. After mastectomy, your missing tissue is replaced with a breast implant or tissue from your abdomen, thighs, buttocks, hips, or back.

A total (or simple) mastectomy removes breast tissue, breast skin, nipple, and areola.

A skin-sparing mastectomy removes the breast tissue, including the nipple and areola, but preserves the remaining breast skin.

A nipple-sparing mastectomy removes breast tissue, but
also preserves the nipple and areola.

A modified radical mastectomy removes breast tissue, breast skin, nipple, and areola, and some or all underarm lymph nodes.

A radical mastectomy removes the entire breast, chest wall muscles under the breast, and all underarm lymph nodes. This is usually performed only when a tumor is found in the chest wall.

Male mastectomy

Men have breast tissue, and they too can develop breast cancer and may require a mastectomy. The estimated lifetime risk for men is quite low, about 1 in 755 compared with 1 in 8 women of average risk. Preventive or contralateral mastectomy may be recommended for men who have an unusually high risk for breast cancer due to family history and/or an inherited mutation in a high-risk gene.

How long is recovery?

You might need 3 to 4 weeks or more before you get back to most or all of your routine activities.

It may take 1 to 3 weeks longer to fully recover from mastectomy with immediate reconstruction, depending on the procedure.

How long does it take?

Mastectomy without reconstruction takes 1 to 3 hours.

Mastectomy with immediate reconstruction requires more time, depending on the procedure.

You may stay in the hospital for 1-2 nights; many people go home the same day.

Facing a mastectomy can be overwhelming, but understanding the procedure, recovery, and what to expect is a powerful way to regain a sense of control while protecting your long-term health.