A mastectomy is performed under general anesthesia. So, you are asleep during the surgery.
The surgeon removes all of the breast tissue. 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).
Image courtesy of Lange Productions (http://langeproductions.com/).
Using a microscope, a pathologist checks the tissue removed during breast surgery. The pathologist determines whether cancer cells are present in the rim of tissue around the tumor (called a margin).
In rare cases after a mastectomy, the deep margin (the margin closest to the chest wall) or skin margin contains cancer cells. In these cases, more surgery and/or radiation therapy may be recommended.
Learn more about assessing tumor margins.
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.
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. This 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.
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 for breast prosthesis 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:
If you wear a breast prosthesis and have concerns about airline security screening, visit the TSA website.
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 you are having reconstruction) and insurance provider.
Learn more about insurance issues related to mastectomy and breast reconstruction.
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.
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 programs to help you with child care and elder care costs.
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 firstname.lastname@example.org.
Breast Cancer 101
1-877 GO KOMEN(1-877-465-6636)