Mastectomy is the medical term for surgical removal of the breast. It refers to many different operations that are often named based upon the approach and tissues removed.
The different types of breast surgery are described below. Based on the size and location of the lump, your doctor will recommend the type of surgery that offers you the best chance of successful treatment.
Most medical and surgical procedures carry some risk. The risks are categorized small or serious, frequent or rare. Because there is such a wide range of potential risks and benefits from various treatments for the different stages and kinds of breast cancer, you should discuss with your doctor the particular benefits and risks of treatment methods suitable for you.
Nipple sparing mastectomy
This procedure essentially removes the breast tissue and leaves the skin and nipple complex in place. It may be ideal for patients undergoing prophylactic surgery and women with cancers that do not involve the nipple complex. The ability to perform this operation is based upon the size of the breast, ptosis or “droop” of the breast and tumor size and location.
Advantages: Cosmetically, in the appropriate patient, the results are superior to other reconstruction options.
Disadvantages: The remaining nipple complex will usually lose its sensation. There is a chance that the nipple will lose a portion of its skin due to lack of blood flow. Currently, there are no means of imaging the remaining tissue of the nipple. It is considered as safe as a total mastectomy for treatment of cancer.
Skin sparing mastectomy
This mastectomy is performed through a small keyhole, only removing the nipple/areola complex. It allows for excellent cosmetic results from reconstruction and does not increase the risk of local recurrence, if the skin is not involved by tumor.
Advantages: Cosmetic results are superior to a standard mastectomy scar.
Disadvantages: The skin flap may lose adequate blood flow to remain alive.
Total or simple mastectomy
This type of surgery removes only the breast. A few of the underarm lymph nodes closest to the breast are removed to assure complete removal of the axillary tail of the breast. This is most often used to treat noninvasive breast cancers or in prophylactic mastectomies.
Advantages: Most or all of the underarm lymph nodes remain, so the risk of swelling of the arm is greatly reduced. Breast reconstruction is easier.
Disadvantages: The breast is removed.
Modified radical mastectomy or total mastectomy with axillary node dissection
This procedure removes the breast, the underarm lymph nodes and the lining over the chest muscles. It is also called “total mastectomy with axillary dissection.”
Advantages: Keeps the chest muscle and the muscle strength of the arm. Swelling is less likely, and when it occurs, it is milder than the swelling that can occur after a radical mastectomy. It leaves a better appearance than the radical mastectomy. Survival rates are the same as for the radical mastectomy when cancer is treated in early stages. Breast reconstruction is easier and can be planned before surgery.
Disadvantages: The breast is removed. In some cases, there may be swelling of the arm because of the removal of the lymph nodes (~12-15 percent risk of lymphedema).
Radical Mastectomy
This type of surgery removes the breast, the chest muscles, all of the underarm lymph nodes, and some additional fat and skin. It is also called a “Halsted Radical” (after the surgeon who developed the procedure). A radical mastectomy was the standard treatment for breast cancer for over 70 years but is now rarely used.
Questions?
We are here to help answer your questions or assist you with scheduling an appointment. Call us today.