Total Mastectomy
Total Mastectomy
What is a Total Mastectomy?
Total mastectomy is also sometimes referred to as simple mastectomy. It is a surgical procedure in which the entire breast is removed including the skin, the nipple area, and some or all of the lymph nodes. 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 total mastectomy can be a unilateral or single mastectomy, [Link to Unilateral Mastectomy] where only one breast is removed, or a bilateral or double mastectomy, [Link to Bilateral Mastectomy] where both breasts are removed.
What are the Benefits of a Total Mastectomy?
A total mastectomy is a common treatment option for individuals diagnosed with breast cancer. It's also a good option for those who choose to have a prophylactic, or preventative, mastectomy because they are at a high-risk of developing the disease. While the decision to undergo this surgery can be daunting, it does have significant benefits that can improve both physical and emotional well-being.
- Reduced Risk of Cancer: If you have a high risk of developing breast cancer due to your family history, [Link to Family History] BRCA gene mutations, or other reasons, choosing to have a mastectomy as a preventative measure will reduce the risk of developing cancer. Depending on your own personal circumstances and health concerns, you may choose to have one or both breasts removed.
- Reduced Risk of Cancer Recurrence: In women already affected by breast cancer, by removing all of the breast tissue, a total 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.
- Enhanced Aesthetic Results: For many individuals, undergoing a total mastectomy can lead to improved aesthetic results compared to some other surgical options like a lumpectomy. With advancements in reconstructive surgery techniques, there are good options for restoring symmetry and achieving natural-looking results following surgery using either implants or your own tissue removed from elsewhere in your body.
- Psychological Benefits: Dealing with a breast cancer diagnosis and undergoing treatment can take an emotional toll on women. Choosing a total mastectomy may help you feel empowered by taking control of your health and making proactive decisions about your treatment plan.
The benefits of a total mastectomy extend beyond physical health improvements to include emotional well-being and quality of life enhancements for many women facing a breast cancer diagnosis. Consulting with your doctors about your individualized treatment options is critical in determining the most appropriate course of action based on your unique circumstances and preferences.
Who is a Good Candidate for a Total Mastectomy?
A woman may choose to have a total mastectomy as a preventative measure because she is in a high-risk category for developing breast cancer. In that case, she would be most likely to have a bilateral (double) mastectomy. [Link to Bilateral Mastectomy] In addition, the following conditions make you a good candidate for this procedure:
- Early-Stage Breast Cancer: If the cancer has been caught early and not had the opportunity to progress far, skin-sparing mastectomy [Link to Skin-Sparing Mastectomy] is often recommended. However women with early-stage breast cancer who are eligible for breast-conserving surgery might choose to undergo a total mastectomy instead.
- Large Tumor: In some cases, if the tumor is too large to be effectively treated with other methods, a total mastectomy may be necessary to remove all traces of cancerous tissue.
- Family History of Breast Cancer: Those who have close relatives (such as mother, sister, or daughter) who have been diagnosed with breast cancer may be at an increased risk themselves. In these cases, a total mastectomy may be considered as a preventive measure to reduce the risk of developing breast cancer in the future.
- Genetic Mutations: Some women carry genetic mutations (such as BRCA1 or BRCA2) that significantly increase their risk of developing breast cancer. In this case, a total mastectomy may be recommended as part of their overall risk-reduction strategy.
What Should I Expect From My Surgery?
During a total 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.
After having a total 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.
It's important to consider whether you may need radiation therapy after your surgery, as it can affect your options for breast reconstruction. Some patients may know in advance that radiation will be part of their treatment plan, while for others, this decision may depend on the results of the mastectomy. You may have a consultation with a radiation oncologist before or after surgery to discuss the potential benefits and risks.
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
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.