A mastectomy is a way to treat breast cancer by surgically removing a breast and sometimes nearby tissues while breast-conserving surgery (also known as a lumpectomy) is the removal of the cancer and some of the surrounding tissue while leaving healthy breast tissue behind. Studies have shown that both a mastectomy and a lumpectomy with radiation have similar survival rates. Both options have their own pros and cons and your doctor will discuss all treatment options with you so you can make the decision that is best for you.

The procedure is part of treatment for breast cancer.
  1. Partial or segmental mastectomy is another name for a lumpectomy or breast-conserving surgery, which is the removal of the cancerous tumor and some healthy breast tissue around it. All removed tissue will be sent to the laboratory for examination to determine what further treatment (if any) is needed.
  2. Total or simple mastectomy is the removal of the breast tissue, nipple, areola and skin but not all the lymph nodes. During this procedure the doctor will examine the lymph nodes and remove any necessary to test for metastasis.
  3. Modified radical mastectomy is the removal of the whole breast, including the breast tissue, skin, areola, nipple, and most of the axillary lymph nodes. The lining over the chest muscles may be also removed.
  4. Radical mastectomy is the removal of the whole breast, the underlying chest muscle, and the axillary lymph nodes. This procedure is done if the cancer has spread into the chest muscle.
Mastectomy is done using general anesthesia so your doctor will carry out a thorough physical examination as well as order further tests, including blood tests, chest x-ray, and an electrocardiogram (EKG). You will likely undergo imaging studies that may include mammogram, breast ultrasound, and breast magnetic resonance imaging (MRI). Please let your doctor know about all medication that you are taking as some will need to be stopped before the procedure. You will need to avoid food and water for six to eight hours before the procedure or as recommended by the doctor.
Please discuss the exact procedure with your doctor as the surgery is different from person to person and doctor to doctor.
After the surgery, you will be moved to a recovery room until the effects of anesthesia have worn off. You will likely stay in the hospital for at least two to three nights, depending on the extent of the procedure. If you experience any side effects from the anesthesia, such as headache, nausea, and/or vomiting, please let the nurses know so they can give you medication to manage your symptoms.
  • Incision. To close the surgical incision the doctor may use dissolvable or regular stitches or both together. Depending on the type of surgery you will likely have one or two drains (per side) to remove blood and fluid from the area. These drains are usually removed three to four days after the procedure. You will receive instructions on caring for the incision, which will normally be covered until your next appointment.
  • Exercise. It is normal to feel tired after the procedure. Resume normal activities are you are comfortable doing so. Do not drive for one to two weeks after the procedure and not until you have a reasonable range of motion in your arm and shoulder. You will be given instructions on exercises to help maintain and/or restore range of motion in the affected arm.
  • If lymph nodes are removed or radiation is administered to the axillary nodes you must be very careful with the arm on that side due to the risk of lymphedema. Avoid having blood pressure taken on that arm. Avoid blood draws and other medical procedures on that arm. Do not carry excessive weight or wear tight clothing or jewelry on that arm. To the best of your ability, avoid cuts, burns, and insect bites on that arm.
  • Sexuality and self-esteem. It is normal to experience self-esteem and sexuality issues after a mastectomy and some patients can benefit from therapy before and after the procedure as well as counselling for both partners.
  • Infection at the incision, causing pain, swelling, and leakage of discharge.
  • Collection of fluid or blood under the skin.
  • Poor healing can occur, caused by lack of blood supply to the wound.
  • Due to nerves being severed, numbness of the arm and the chest may occur. Weakness of the arm on the affected side may also occur. This can be temporary or permanent.
  • Stiffness in the shoulder or arm on the affected side can limit range of motion. This is usually resolved by performing physical therapy soon after the surgery.
  • Abnormal healing, causing adhesions and/or pain, which are often permanent.
  • Lymphedema occurs in one in four patients who have axillary nodes removed. This risk increases with the number of nodes removed and how well the affected arm is cared for. It is important to avoid injury and infection as well as weight gain. Lymphedema generally develops about 20 months after surgery. Compression sleeves and massage can help manage the condition, but it is permanent.
  • A local, regional, or distant recurrence, all of which will require additional treatment, whether surgery, chemotherapy, radiation therapy, and/or hormone therapy.
  • Pain after surgery occurs in two out of three patients between the ages of 30-49 and one out of four patients older than 70. Post-mastectomy pain may be chronic or may improve with time, depending on the patient. Pain medication can be taken to manage this symptom.
  • Anxiety and/or depression is experienced by one in three patients after a mastectomy. Therapy can help.
  • Risks are more likely in patients who are obese and who smoke. These patients are more likely to experience infection at the incision site, lung infection, cardiac and pulmonary complications, and blood clots.
  • If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure.
  • Travelers to Thailand should plan to stay in the country for at least two weeks or for the entire duration of treatment.
  • If you plan to return home after the procedure, please speak to your doctor before making travel arrangements.
  • During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).
The success of a mastectomy depends on many factors. Please discuss this with your doctor.
What if the procedure is not performed?
Without treatment, cancer will spread to other parts of the body.
Treatment of breast cancer depends on the type and extent of the cancer. Please discuss all treatment options with your doctor.

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