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  • Mastectomy - The Procedure



    Mastectomy Video
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    Breast Cancer 101 (Interactive Multimedia) - Mastectomy
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    Recovery After Breast Surgery
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    A mastectomy is performed under general anesthesia, which means you are unconscious (asleep) during the surgery. The surgeon removes all of the breast tissue (and in most, but not all cases the nipple and areola are also removed).

    The surgeon closes the skin with stitches and attaches a temporary tube so that fluid from the wound can drain out (see image below). 

     Surgical drains after mastectomy

     Image courtesy of Lange Productions (http://langeproductions.com/).

    Assessing tumor margins

    A pathologist checks the rim of normal tissue around the tumor that is removed during breast surgery to see if cancer cells are present. In rare cases after a mastectomy, this tissue contains cancer and more surgery may be done.

    Learn more about assessing tumor margins

    Assessing lymph nodes (Has the cancer spread to the lymph nodes?)

    During a mastectomy for invasive breast cancer (and in some cases of ductal carcinoma in situ (DCIS)), some of the lymph nodes in the underarm area (axillary nodes) are removed to check for cancer cells. The axillary nodes are the first place breast cancer is likely to spread. The presence or absence of cancer in these nodes is one of the most important factors affecting cancer stage and prognosis.

    Learn more about assessing axillary lymph nodes

    Mastectomy with and without breast reconstruction

    Breast reconstruction

    Some women choose to have breast reconstruction to help restore the look and feel of the breast that was removed. This may be done at the same time as the mastectomy (immediate) or later (delayed).

    For some women who choose immediate reconstruction, surgeons may use a special skin-sparing technique (and possibly a nipple-sparing technique) during the mastectomy, which saves much of the skin of the breast. The plastic surgeon can use this skin as an envelope to help form the reconstructed breast.

    Some women choose not to have reconstructive surgery or to do it later. When no reconstruction is planned, the surgeon will leave the area as flat as possible so that a breast prosthesis can be comfortably fitted to the chest.

    Learn more about breast reconstruction.

    Learn about insurance coverage and financial assistance for breast reconstruction

    Breast prosthesis

    If you don’t want to have reconstruction, you can get a breast prosthesis. This is a breast form made of silicone gel, foam or other materials that is fitted to your chest. The form is either placed directly on top of your skin or in the pocket of a special bra.

    Your health care provider can discuss breast prosthesis options with you and help you choose the type that best fits your lifestyle. Your prosthesis can be properly fitted several weeks after your mastectomy surgery.

    Learn about insurance coverage and financial assistance for breast prosthesis

     Breast prosthesis and air travel

    Susan G. Komen wants to ensure breast cancer survivors are treated with respect and dignity. Here are some steps you can take that may help as you plan your travel:

    • You may want to arrive earlier than usual at the airport, so you have time to go through secondary screening if necessary.
    • If you are concerned about going through the body scanner for any reason, you may request a private pat-down screening. 
    • If you choose, or are selected for, a pat-down screening, you may request a private screening away from public areas.
    • If you feel comfortable doing so, tell the Transportation Security Administration (TSA) agent you are a breast cancer survivor and are wearing a breast prosthesis. If you prefer to give this information more discreetly, the TSA now offers a notification card you can give to the agent (find this card on the TSA website). 
    • You should not be asked to lift or take off any clothing to show your breast prosthesis, nor should you be asked to remove it.

    • Most airlines strongly recommend that customers pack breast prosthesis (if not wearing it) or medications in carry-ons, rather than in checked luggage.

    If you wear a breast prosthesis and have concerns about airline security screening, visit the TSA website for the latest information and a list of other tips to make the process as comfortable as possible.

    Length of hospital stay

    Most people will stay in the hospital at least overnight after a mastectomy. If breast reconstruction is done, the stay may be longer, depending on the procedure. You should discuss the expected length of stay with your surgeon, plastic surgeon (if having reconstruction) and insurance provider.

    Learn more about insurance issues related to mastectomy and breast reconstruction.

    What to expect after mastectomy

    After mastectomy (with or without breast reconstruction), you will likely have temporary soreness in your chest, underarm and shoulder. You will be numb across your chest (from your collarbone to the top of your rib cage). Unfortunately, this numbness is usually permanent. You may get some feeling back over time, but it will never be the same as before surgery.

    If lymph nodes in the underarm area (axillary nodes) are removed during surgery, you may also have some numbness in your arm and there is some risk of lymphedema. Lymphedema is a condition where fluid collects in the arm (or other area such as the hand, fingers, chest or back), causing it to swell.

    Learn more about the management of surgery-related pain.

    Learn more about lymphedema.

    Transportation, lodging, child care and elder care assistance

    You may not live near the hospital where you will have your surgery. Sometimes, there are programs that offer help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you. There are also financial assistance programs to help you with child care and elder care.

    Learn more about transportation, lodging, child care and elder care assistance.

    Susan G. Komen’s Breast Care Helpline:
    1-877 GO KOMEN (1-877-465-6636)

    Calls to our breast care helpline are answered by a trained and caring staff member Monday through Friday from 9:00 a.m. to 10:00 p.m. ET and from 6:00 a.m. to 7:00 p.m. PT. Our helpline provides free, professional support services to anyone with breast cancer questions or concerns, including breast cancer survivors and their families. You can also email the breast care helpline at helpline@komen.org.

    Updated 07/28/15


    010673.gif    Mastectomy
     010673.gif Surgery
    Lumpectomy  010674.gif  
    Lumpectomy – the Surgical Procedure  010674.gif
    Deciding Between Mastectomy and Lumpectomy Plus Radiation Therapy   010674.gif
    Breast Reconstruction   010674.gif
    Questions for Your Provider - Surgery  010674.gif


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