For a simple mastectomy (also called a total mastectomy)
The surgeon removes:
– All of the breast tissue.
– The skin of the breast.
– The nipple and the areola. (the dark area around the nipple)
Mastectomy may be recommended for you if:
The tumor is larger than 5 centimetres.
There are two or more tumors in different parts of your breast.
You have an inherited gene mutation that increases your risk of developing second breast cancer, such as a BRCA1 or BRCA2 mutation.
You have inflammatory breast cancer.
You have multiple or very large areas of ductal carcinoma in situ (DCIS).
Your breast is small and a lumpectomy would leave you with very little breast tissue.
Your surgeon has already made multiple attempts to remove the tumor with lumpectomy but has not been able to completely remove the cancer and get clear margins.
Your doctor recommends you avoid radiation therapy because you had prior radiation to the same breast, you have a disease that makes you sensitive to radiation side effects (such as scleroderma or lupus), or you are pregnant you had breast cancer before in the same breast you believe mastectomy would give you greater peace of mind than lumpectomy.
A mastectomy without immediate breast reconstruction can take 1-3 hours. If immediate breast reconstruction is performed during the mastectomy, the surgery will take longer (about 3 to 4 hours for reconstruction with tissue expanders or breast implants and 6 to 8 hours for reconstruction with tissue flaps).
During the mastectomy, the surgeon separates the breast tissue from the skin and muscle. All of the breast tissue that the surgeon can see — which lies between the collarbone and ribs, from the side of the body to the breastbone in the centre — is removed. Depending on the type of mastectomy you are having, your surgeon may remove other parts of the breast.
You will have drains in each operated breast and stay overnight in the hospital. Most patients complain of chest tightness after this surgery. You will be prescribed muscle relaxants that will help with the tightness.
Taking pain medication.
Caring for the bandage (dressing) over your incision, surgical drain and stitches.
Recognizing signs of infection-fever, increased redness around the incision, and pus draining from the incision.
Exercising your arm ( In case SLNB or ALND was performed).
Recognizing signs of lymphedema ( In case SLNB or ALND was performed).
You can wear a breast prosthesis or bra after the wound heals.
