Mastectomy
What is a mastectomy?
The aim of mastectomy is to remove all the breast tissue. There are different types of mastectomy. Reconstruction is always discussed when mastectomy is recommended. A/Prof Mak or Dr Graham will discuss with you in detail the reason a mastectomy is recommended, what type of mastectomy is best suited and whether breast reconstruction is appropriate. This will depend on your breast and body shape as well as the location and type of tumour. A mastectomy is not able to remove 100% of the breast tissue.
Simple mastectomy (also called Aesthetic Flat Closure) - this procedure aims to remove all the breast tissue, the nipple and some of the breast skin. After the operation, your chest wall will appear flat and there is flat straight scar across your chest where the breast was.
Skin sparing mastectomy – this procedure aims to remove all the breast tissue and the nipple, leaving most of the breast skin. This type of mastectomy is performed in conjunction with some type of breast reconstruction.
Nipple sparing mastectomy - this procedure aims to remove all the breast tissue whilst leaving the nipple and breast skin intact. This type of mastectomy is performed in conjunction with some type of breast reconstruction.
What are the benefits of mastectomy for breast cancer (compared to breast conservation surgery)?
In most cases, radiotherapy is not required after surgery, but this depends on the size and type of tumour
Mammograms are no longer required on the side of the mastectomy
What are the disadvantages of mastectomy for breast cancer (compared to breast conservation surgery)?
The whole breast is removed. Following simple mastectomy, this will leave you with a flat chest. Some women find this quite upsetting and confronting. In most cases a breast reconstruction is available either at the time of mastectomy or at a later time. It is also possible to wear a prosthesis in your bra if you choose not to have surgical reconstruction.
You may feel unbalanced or lopsided after one breast is removed, particularly if you have large breasts. In some cases breast reduction on the other side is possible to compensate for this.
Your stay in the hospital will generally be one to two days longer if you have a mastectomy rather than breast conservation surgery. This is because it is a bigger operation and there is usually a drain (plastic tube) in the wound to stop a build-up of fluid.
There is a higher likelihood of developing a seroma (a collection of fluid under the arm or on the chest or breast) than after breast conserving surgery.
How long is the operation and what is the recovery like?
Everyone is different, the length of the operation will depend on what type of mastectomy is performed and whether reconstruction is performed at the same time. Recovery will also depend on what type of mastectomy is performed and whether reconstruction is performed at the same time. A/Prof Mak or Dr Graham will discuss the surgery and recovery with you in detail at your consultation.
What are the complications of a mastectomy?
All operations have potential side effects and complications. Fortunately, these are uncommon and surgery usually proceeds without any problems. A/Prof Mak or Dr Graham will discuss the risks and possible complications with you in detail at your consultation. The potential risks and complications will also depend on what type of mastectomy you have and whether breast reconstruction is performed at the same time.
These complications include but are not limited to pain, bleeding, infection, skin healing problems, numbness or decreased sensation, seroma (a collection of fluid under the wound), cosmetic changes, shoulder and arm stiffness and the need for further surgery.
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A/Prof Mak and Dr Graham advocate the National Law and Australian Health Practitioner Regulation Agency (AHPRA) guidelines that any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.