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 puts in 1-2 tubes (surgical drains) so fluid from the wound can drain out (see image below). The drain(s) stays in for about a week to 10 days after surgery.
Image courtesy of Lange Productions (http://langeproductions.com/).
A pathologist checks the tissue removed during breast surgery.
Using a microscope, the pathologist determines whether cancer cells are present in the rim of tissue around the tumor (called a margin).
With a mastectomy, the whole breast is removed during surgery. So, whether the margins contain cancer cells doesn't usually affect your treatment.
In rare cases after a mastectomy, the deep margin (the margin closest to the chest wall) or skin margin (called the superficial margin) contain cancer cells. In these cases, more surgery and/or radiation therapy may be recommended.
Learn more about assessing tumor margins.
If breast cancer spreads, the lymph nodes in the underarm area (axillary nodes) are the first place it's likely to go.
During a mastectomy for invasive breast cancer, some of the axillary lymph nodes are removed to check for cancer cells. The presence or absence of cancer in these nodes is an important factor affecting cancer stage and prognosis.
Learn more about assessing axillary lymph nodes.
Once a mastectomy has been done, a person can no longer have a sentinel node biopsy. So, when mastectomy is used to treat DCIS, a sentinel node biopsy is usually done.
If it turns out there’s also invasive breast cancer (in addition to DCIS) in the tissue removed during the mastectomy, the sentinel node biopsy will have already been done. This helps some women avoid an axillary dissection (a more invasive surgery to remove axillary lymph nodes).
Learn more about sentinel node biopsy and mastectomy for DCIS.
Some women choose to have breast reconstruction to help restore the look and feel of the breast that was removed.
Reconstruction may be done at the same time as the mastectomy (immediate) or later (delayed). In general, cosmetic results are better with immediate reconstruction.
It's important to discuss your reconstruction options with your plastic surgeon before your breast surgery.
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.
Learn more about breast prosthesis.
Learn about insurance coverage for breast prosthesis and financial assistance for breast prosthesis.
Most people will stay in the hospital overnight after a mastectomy.
If breast reconstruction is done, the stay may be longer, depending on the type of reconstruction.
It's a good idea to 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 have some 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 and a burning feeling under and behind your arm. There is also 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.
You may not live near the hospital where you will have your surgery.
Sometimes, there are programs that 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 people diagnosed with breast cancer and their families.
You can also email the helpline at firstname.lastname@example.org.
Breast Cancer 101
1-877 GO KOMEN(1-877-465-6636)