When someone close to you is diagnosed, the vocabulary arrives fast. This is a plain explanation of one word you will hear a lot.
This article is general health information, not medical advice. Talk to a healthcare professional about your own situation.
What a mastectomy is
Surgery that removes all the breast tissue from one breast (unilateral) or both (bilateral), sometimes with some skin and, rarely, muscle. It is done to treat breast cancer or to prevent it in people at very high risk.
The main types
- Simple (total) mastectomy. All breast tissue and most of the skin over it.
- Skin-sparing. All breast tissue and the nipple, keeping most of the skin, which makes reconstruction easier.
- Nipple-sparing. Skin-sparing that also keeps the nipple and areola.
- Modified radical. Breast tissue, skin and nipple plus lymph nodes under the arm; the chest muscles stay.
- Radical. Now rare: breast, skin, chest muscles and lymph nodes.
Why mastectomy rather than lumpectomy plus radiation
Many early cancers are treated by removing the tumor and treating the rest of the breast with radiation. A surgeon may recommend mastectomy instead when:
- There are two or more tumors in different parts of the breast.
- Suspicious calcifications are spread through the breast.
- The breast has already had radiation and the cancer has returned.
- Pregnancy makes radiation unsafe.
- A lumpectomy left cancer at the edges of the removed tissue.
- A gene mutation carries a high risk of a second cancer.
- The tumor is large relative to the breast.
- A connective tissue condition makes radiation hard to tolerate.
The final choice is the patient's, made with the surgical team.
What comes after
Recovery, possible reconstruction, and a lot of feelings. We wrote about the emotional side, a hospital-stay checklist and what to say to a friend.
Frequently asked questions
Is a mastectomy the same as breast removal?
Yes. It removes the breast tissue; how much skin and muscle depends on the type.
Can you have reconstruction after a mastectomy?
Often, either at the same time or later. Skin- and nipple-sparing types are chosen partly for this.
Where can I read more?
The American Cancer Society and Breast Cancer Now publish detailed, plain-language guides.