Your doctor may recommend removing one or both of your breasts to treat or prevent breast cancer. At the Abramson Cancer Center, our multidisciplinary breast cancer surgery team includes breast surgeons, plastic surgeons, and genetic counselors. We’ll explain your options, answer your questions and help you decide if a mastectomy is the best choice for you.
What Is a Mastectomy?
A mastectomy is a surgical procedure to remove one or both breasts. We may use mastectomy for many reasons, including:
- Tumor location or size: Large tumors or cancer located throughout the breast cannot be treated with lumpectomy, which only removes part of the breast.
- Cancer risk: Mastectomy may be recommended as a preventative measure for patients at a high risk for developing new or recurring breast cancer.
- Personal reasons: Patients may have a personal preference for mastectomy over breast conserving surgery.
Mastectomy: Why Choose the Abramson Cancer Center?
At Penn Medicine mastectomies involve a team of experts. From preoperative education to post-surgical support, we offer compassionate care and advanced expertise every step of the way. The benefits of surgery at the Abramson Cancer Center include:
- Expert surgeons: Our specialized breast surgeons perform mastectomy to fit your body and needs. If you desire a reconstruction, our plastic surgeons expertly restore your appearance.
- Latest surgical techniques: We perform the latest breast cancer surgeries. Our clinical trials provide access to promising new mastectomy techniques such as robotic nipple sparing surgery.
- Risk evaluation and counseling: Our cancer risk experts at MacDonald Cancer Risk Evaluation Center determine your risk of breast cancer. If you have a high risk of hereditary breast cancer, the Basser Center for BRCA offers specialized guidance and support.
- Specialty boutiques: Our cancer center boutiques, located at two Penn Medicine hospitals, offer products and services designed for breast cancer patients. We provide bra fittings and intimate apparel to help you feel confident and comfortable after mastectomy.
How We Treat Cancer With Mastectomy
We use mastectomies to treat all types of breast cancer. For early stage cancer, mastectomy is an alternative to treatment with lumpectomy plus radiation therapy. For more advanced or recurrent cancer, mastectomy is often the best or only surgical option. For men with breast cancer, mastectomy is often the best treatment, because most tumors in men occur beneath the nipple.
Our surgeons perform mastectomies with or without breast reconstruction. The types of mastectomies we offer include:
Simple mastectomy is breast removal without breast reconstruction. The surgeon removes one entire breast, including the nipple, areola and skin. We typically remove lymph nodes during the procedure as well, unless the surgery is to prevent breast cancer from developing. This surgery is used to treat early forms of breast cancer, such as ductal carcinoma in situ (DCIS), as well as invasive cancer.
Skin Sparing Mastectomy
The surgeon removes the entire breast tissue including the nipple and areola, but leaves the skin in place. Patients who have this type of surgery have breast reconstruction done immediately.
Nipple Sparing Mastectomy
For some patients, our surgeons can remove the breast tissue while leaving the skin, areola and nipple. This surgery is only an option when cancer is not detected in the tissue underneath the nipple. Patients who have this type of surgery have breast reconstruction done immediately.
Modified Radical Mastectomy
A modified radical mastectomy involves the removal of the breast tissue and all lymph nodes. We use this procedure mostly for patients with advanced or aggressive breast cancer. Removing the lymph nodes allows us to determine whether cancer has spread beyond the breast.
During this operation, also called a bilateral mastectomy, the surgeon removes both breasts. We use double mastectomies to treat advanced cancer. Patients who have a high risk of breast cancer may have a double mastectomy as a risk reduction procedure. For some patients, this type of mastectomy can be nipple sparing.
What to Expect During Mastectomy
Our surgical team helps you prepare for surgery and answers any questions you may have. We coordinate pre-surgery appointments including consultations with the breast surgeon and plastic surgeon, if you plan to have breast reconstruction.
The surgery is performed using general anesthesia. During the procedure, your breast surgeon will:
- Make an incision around your breast and remove breast tissue for review by a pathologist
- Possibly remove lymph nodes for further investigation by a pathologist
- Work in conjunction with a plastic surgeon whenever possible to perform breast reconstruction during the mastectomy
- Close the incision and place temporary drains (plastic tubes) to remove any fluid build-up near the surgery site
Recovering From Mastectomy
After a mastectomy, we will monitor your vital signs, including heart rate and blood pressure, as the effects of anesthesia wear off. Many women return home within a day of surgery. Your hospital stay may be extended if you chose to have breast reconstruction at the same time. You may experience some discomfort in your chest, armpit and shoulder for a few days following surgery.
Full recovery should take approximately four weeks. Before you head home, we’ll walk you through the recovery instructions and offer guidance on when you can begin to wear a bra or prosthesis. We coordinate a follow-up visit with your surgeon. At that time, we’ll remove any drains, check the incisions and review the pathology report.
Breast Reconstruction After Mastectomy
Breast reconstruction is a surgical procedure that restores the appearance of one or both breasts following mastectomy. Plastic surgeons reconstruct breasts using either breast implants, the patient’s own tissue (typically removed from the lower abdomen) or a combination of the two methods.
At Penn, breast reconstruction is typically an option after a mastectomy. We perform the highest volume of breast reconstructions in the nation. Our expert plastic surgeons can reconstruct your breasts at the same time as your mastectomy or at a later time. We’ll guide you through all your reconstruction options, so that you can make an informed decision. Learn more about breast reconstruction at Penn Medicine.