Mastectomy (total breast removal surgery)

A mastectomy is a surgical procedure that removes the breast tissue to treat breast cancer. Mastectomies may be unilateral (single mastectomy), in which one breast is removed, or bilateral (double mastectomy), in which both breasts are removed. Mastectomies differ from lumpectomy procedures in that the entire affected area of the breast as well as all the surrounding breast tissue is removed, whereas lumpectomies are only a partial removal.

If you have a more high-risk or late-stage breast cancer diagnosis or an increased risk of developing breast cancer, your doctor may recommend removing one or both of your breasts to treat or prevent breast cancer. 

We may use mastectomy for many reasons, including: 

• Large or vast tumors: Tumors that are large in size or cancer located throughout the breast cannot be treated with lumpectomy, which only removes part of the breast. 
• High-risk cancer: Mastectomy may be recommended as a preventative measure for patients at a considerable risk for developing new or recurring breast cancer. 
• Personal reasons: Patients may have a personal preference for mastectomy over breast conserving surgery. 

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 mastectomy 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 

After a mastectomy, our team will monitor your heart rate, blood pressure, and other vital signs while the anesthesia wears off to ensure no complications from receiving the anesthetic. Many patients who undergo a mastectomy will return home within a day of surgery, but the hospital stay may be extended if the choice to have breast reconstruction at the same time is made. 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 will 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 will remove any drains, check the incisions, and review the pathology report. 

Breast reconstruction is a surgical procedure that restores the appearance of one or both breasts following mastectomy. Plastic surgeons reconstruct the breasts using either breast implants, the patient’s own tissue (typically removed from the lower abdomen) or a combination of the two methods. 

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 will guide you through all your reconstruction options, so that you can make an informed decision. 

Learn more about breast reconstruction at Penn Medicine

At Penn Medicine, mastectomies involve a team of experts through our Breast Cancer Program. 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 Penn 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.