What is a mastectomy?

A mastectomy is surgery to remove the breast. Every woman's treatment plan and breast surgery are different. Your doctor will tell you about your surgery and whether any lymph nodes will be removed.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to make yourself feel better while you go through treatment. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

What are the types of mastectomy?

• In a simple or total mastectomy, the entire breast is removed. The lymph nodes may be removed. This surgery is often done for women who have ductal carcinoma in situ (DCIS) or for women who have invasive breast cancer. This surgery is also used for women who are having a breast or both breasts removed to prevent breast cancer.
• In a modified radical mastectomy, the entire breast and the lymph nodes under the arm (axillary lymph nodes) are removed.
• In breast-conserving surgery, the tumour and some healthy breast tissue are removed. Most of the breast remains. The doctor may remove only the cancer and a small part of the breast up to about a quarter of the breast. The amount of breast tissue that is removed is different for each surgery.
• A skin-sparing technique may be used for a simple or modified radical mastectomy. The breast tissue is removed through a cut that is made around the nipple. This technique does not harm the skin. Sometimes the nipple can be saved. Lymph nodes may be removed through the same cut made around the nipple or through another cut in the armpit.
• A radical mastectomy is very rarely done. In this surgery, the entire breast, all of the lymph nodes in the armpit, muscles under the chest, and some of the surrounding fatty tissue are removed. It is used only when a woman has many tumours and when cancer has entered the chest.

The type of surgery you have depends on:

• The tumour size, type, and location.
• The size of your breast.
• The cancer stage.
• Whether or not the cancer has spread to the lymph nodes.
• Whether or not you've had radiation treatment.
• Your age and health.

You and your doctor can decide which surgery is right for you.

What can you expect after surgery?

Breast cancer surgery helps many women go on to lead normal lives. Your outcome depends on many things, especially the stage of the cancer.

You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any further treatment. Talk with your doctor about other treatment you may need.

Your personal preferences and considerations are important when choosing a treatment that is right for you.

Lymph nodes

If you had an axillary lymph node dissection at the time of your surgery, many lymph nodes were removed from your armpit area. Without these lymph nodes, your arm may swell. This is called lymphedema. You will have to take good care of your affected arm. Don't carry heavy things with that arm. Wear loose sleeves and bracelets. Your doctor or physiotherapist can teach you arm exercises that will let you move your arm as you always have.

Before you get blood pressure tests, blood draws, or shots in that arm, tell your doctor that you had lymph nodes removed.

Appearance

You will have a scar, but it will fade in time.

You have some choices in how you look. Talk to your doctor about breast forms. Ask about reconstructive surgery. This can sometimes be done at the same time as the mastectomy.