Modified Radical Mastectomy

A modified radical mastectomy is similar to a total mastectomy [Link to Total Mastectomy] in that it involves removing all of the breast tissue. However, with a total mastectomy only some of the lymph nodes may be removed whereas in a modified radical mastectomy most of the lymph nodes are taken.

This type of surgery is normally performed to treat breast cancer [Link to Treatment Options] or reduce the risk of developing the disease in high-risk individuals. While it can be a challenging decision for many women to undergo this procedure, a modified radical mastectomy can have benefits in terms of reducing the risk of cancer and the chance of it recurring.

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What is a Modified Radical Mastectomy?

A modified radical mastectomy is a surgical procedure in which the entire breast is removed including the skin, the nipple area, and most of the lymph nodes. The chest wall muscles underneath the breast are left intact, unlike a radical mastectomy in which all the breast tissue, lymph nodes and muscles are removed. Radical mastectomies are rarely performed in modern times unless the cancer has spread to the chest wall.

This type of mastectomy can be performed as a treatment option for breast cancer as well as a preventive measure for individuals who have a high risk of developing the disease, such as those affected by the BRCA gene mutation [Link to BRCA Gene] or other contributing factors.

A modified radical mastectomy can be a unilateral or single mastectomy, [Link to Unilateral Mastectomy] where only one breast is removed with its lymph nodes, or a bilateral or double mastectomy, [Link to Bilateral Mastectomy] where both breasts are removed together with most of the lymph nodes.

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What are the Benefits of a Modified Radical Mastectomy?

This is a common treatment option for individuals diagnosed with more advanced or invasive breast cancer as it also removes the lymph nodes to which the cancer spreads.

Effective Treatment: Because it removes all of the breast tissue and most of the lymph nodes, modified radical mastectomy can be very effective in treating or eradicating cancer altogether.
Reduced Risk of Cancer Recurrence: In women already affected by breast cancer, by removing all of the breast tissue, this type of mastectomy significantly reduces the risk of cancer recurrence. This can provide peace of mind and confidence in knowing that steps have been taken to prevent further spread of malignant cells.
Improved Survival Rates: Studies have shown that individuals who undergo a mastectomy as part of their treatment plan have better survival rates compared to those who opt for other treatments [Link to Treatment Options] or no surgery at all. Removing the tumor and surrounding tissue through surgery can effectively eradicate cancer cells and improve long-term outcomes.
Additional Treatment: In most cases there is no need for radiation therapy following surgery.
Psychological Benefits: Dealing with a breast cancer diagnosis and undergoing treatment can take an emotional toll on women. Having a modified radical mastectomy may help women feel confident that their cancer won't return.

Who is a Good Candidate for a Modified Radical Mastectomy?

A woman may have a modified radical mastectomy if she falls into one or more of the following categories:

Invasive Breast Cancer: If you have invasive breast cancer that has spread to surrounding tissue or the lymph nodes, modified radical mastectomy will normally be the recommended treatment for you.
Inflammatory Breast Cancer: This type of mastectomy is likely to be recommended by your surgeon is you have inflammatory breast cancer because it is a particularly aggressive type of the disease.
Advanced Breast Cancer: If you have stage 3 cancer, a modified radical mastectomy may be part of your recommended treatment plan, although stage 4 breast cancer is not normally treated with surgery.

What Should I Expect From My Surgery?

During a modified radical mastectomy, the surgeon will remove the breast tissue from the affected breast. This will include the nipple, areola, skin, and some or all of the nearby lymph nodes. This is major surgery, so you should be prepared for a lengthy recuperation period.

After having the mastectomy, you may choose to undergo reconstructive surgery [Link to Breast Reconstruction] to restore the appearance of your breasts. This can take place either immediately following the mastectomy in one surgery or at a later date, once recovery from the mastectomy is complete.

Before Surgery

Before your surgery, you'll have a meeting with your surgical team to go over the details of your operation. This is a great opportunity to ask any questions you may have and ensure you fully understand the procedure, its purpose, associated risks, and any alternative treatments available.

Although in most cases you are unlikely to need radiation therapy following a modified radical mastectomy, it's important to consider whether this might be a possibility, as it can affect your options for breast reconstruction.

Your healthcare team will provide you with specific instructions to prepare for surgery, which may include:

Informing your healthcare team about any medications, vitamins, or supplements you're currently taking, as certain substances may interfere with the surgery.
Stopping certain medications, such as aspirin or other blood-thinners, as advised by your healthcare team.
Following guidelines regarding fasting before surgery, which may involve refraining from eating for several hours beforehand and only drinking liquids up to a certain time.
Planning for post-surgery arrangements, such as whether you'll need to stay in the hospital overnight or go home the same day. Arrange for transportation if you're discharged the same day and prepare a bag with essentials for your hospital stay, including toiletries and items for comfort and entertainment.

During Surgery (Procedure Overview)

A mastectomy will normally involve staying in the hospital for at least one night, depending on the type of surgery you will be having. The procedure can vary based on your personal circumstances and your doctor's methods.

You'll be asked to change into a gown.
An IV (intravenous) line will be inserted into your arm or hand to give you medication that will help you relax and put you to sleep during surgery.
You'll lie on your back on the operating table.
Your vital signs, like heart rate and blood pressure, will be monitored throughout the surgery.
The skin around the surgical area will be cleaned with a sterile solution and an incision will be made in your breast.
The breast tissue will be carefully removed together with the nipple and skin.
Some or all of the nearby lymph nodes may be taken out after the breast tissue is removed.
If you're having breast reconstruction at the same time, a plastic surgeon will perform the procedure after the mastectomy. This may be made with a flap of your own tissue removed from elsewhere in your body or with a tissue expander used to stretch the skin in preparation for a further reconstruction operation later.
You may have a surgical nipple reconstruction with or without a tattoo at the same time as your breast reconstruction or at a later date.
The removed tissues will be sent to the hospital lab for examination.
Drainage tubes may be inserted into the area.
The incision will be closed with stitches or adhesive strips and a sterile bandage or dressing will be applied over the site.

After Surgery & Recovery

Recovery from this type of mastectomy will take several weeks, so you should be prepared to take things easy at first. Depending on the type of reconstruction you had, you should be able to walk and move around but shouldn't lift anything heavier than about 5 pounds. You should also ensure you get plenty of rest.

During your hospital stay, you'll be taken to the recovery room after the procedure. There, you'll be closely monitored until your vital signs like blood pressure, pulse, and breathing are stable, and you're awake and alert. Once you're stable, you'll be moved to your hospital room.

Typically, you'll stay in the hospital for 1 to 3 days after a mastectomy, depending on the extent of the surgery and whether you had breast reconstruction. Some types of reconstruction using flaps of your own tissue require more extensive surgery that may result in spending as much as a week in hospital.

Once you're home, it's important to keep the surgical area clean and dry, following your doctor's instructions. You'll also need to care for the drainage tube, which is usually removed after about 2 weeks at your first follow-up exam.

You may experience some pain, which can vary depending on the surgery. Your healthcare team will recommend pain relievers, but be cautious about taking aspirin or certain other pain medicines that may increase the risk of bleeding.

Following lymph node removal, your doctor may recommend exercises to help prevent swelling and stiffness in your shoulder and arm area. These exercises should be started slowly and progressed gradually.

You can typically resume normal activities in a few weeks, but you should avoid strenuous activities in the meantime. Your surgeon will advise you on when you can drive again and return to work.

If you're having difficulty coping with your recovery, you may find it helpful to speak to your loved ones or to join a support group for assistance. This can help you cope with the emotional aspects of undergoing this type of surgery.

Contact your doctor if you experience fever, chills, increased pain, swelling, or any other concerning symptoms after surgery.

Contact us today [Link to Contact] for a confidential conversation by video call directly with one of our expert surgeons. We are more than happy to discuss your treatment options with you if you have already had a cancer diagnosis or are at a high risk for contracting the disease.