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Breast Removing Surgery (Mastectomy)


What Is Mastectomy ?

Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.


"Simple" or "total" mastectomy

Simple or total mastectomy concentrates on the breast tissue itself:


Modified radical mastectomy

Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it. While lumpectomy is technically a form of partial mastectomy, more tissue is removed in partial mastectomy than in lumpectomy.

Subcutaneous ("nipple-sparing") mastectomy

During subcutaneous ("nipple-sparing") mastectomy, all of the breast tissue is removed, but the nipple is left alone. Subcutaneous mastectomy is performed less often than simple or total mastectomy because more breast tissue is left behind afterwards that could later develop cancer.

After breast surgeon has removed your breast tissue, if immediate breast reconstruction is part of your plan, your plastic surgeon will perform the reconstruction.

In the final stages of the surgery, the breast surgeon will check the surgery areas for bleeding and insert surgical drains. Drains are long tubes that are inserted into your breast area or armpit to collect excess fluid that can accumulate in the space where the tumor was. The tubes have plastic bulbs on the ends to create suction, which helps the fluid to exit your body. After the drains are inserted, your surgeon will stitch the incision closed. The surgery site will then be covered by a bandage that wraps closely around your chest.


After mastectomy surgery

You’ll be moved to the recovery room after mastectomy surgery, where staff will monitor your heart rate, body temperature, and blood pressure. If you are in pain or feel nauseous from the anesthesia, let someone know so that you can be given medication.

You’ll then be admitted to a hospital room. Hospital stays for mastectomy average 3 days or less. If you have a mastectomy and reconstruction at the same time, you may be in the hospital a little longer.

The morning after your surgery, the surgeon or nurse will show you an exercise routine you can do to prevent arm and shoulder stiffness on the side where you had the mastectomy and to help prevent the formation of significant scar tissue. Some exercises should be avoided until drains are removed. Ask your surgeon any questions you may have to make sure the exercise routine is right for you. The surgeon should also give you written, illustrated instructions on how to do the exercises.


In the Months after Mastectomy

Your body will continue to adjust to the effects of the surgery over a period of months. Here are some things to keep in mind:


Modified radical mastectomy involves the removal of both breast tissue and lymph nodes:


Radical Mastectomy

Madical mastectomy is the most extensive type of mastectomy:


Mastectomy: What to Expect


Before mastectomysurgery

In the hospital on the day of surgery, you’ll change into a hospital gown and wait in a preoperative holding area

The surgeon or a nurse may draw markings on your breast that show where the incision will be made. Usually this is done with a felt-tip marker. You’ll be sitting up while this happens so that the natural crease of your breast can be marked.

You will be taken into the anesthesia room, where a nurse will insert a needle connected to a long tube — an intravenous infusion (IV) line — into your hand or arm and tape it into place. Soon after this, you’ll be given relaxing medication through the IV line. Once you are wheeled into the operating room, you will be given general anesthesia.


During mastectomy surgery

Mastectomy with axillary dissection (modified radical mastectomy) can take 2-3 hours. If reconstruction is performed at the same time, surgery will take longer.

Most mastectomy incisions are in the shape of an oval around the nipple, running across the width of the breast. If you are having a skin-sparing mastectomy, the incision will be smaller, including only the nipple, areola, and the original biopsy scar.

After the incision is made, the breast tissue is separated from the overlying skin and from the chest wall muscle underneath. All of the breast tissue — which lies between the collarbone and ribs, from the side of the body to the breastbone in the center — is removed. If you are having a full radical mastectomy, some of your chest muscle may be removed as well.


At-home recovery from mastectomy

It can take a few weeks to recover from mastectomy surgery, and longer if you have had reconstruction. It’s important to take the time you need to heal.

In addition to the surgeon’s instructions, here are some general guidelines to follow at home: