Understanding the Mastectomy Surgery

A breast cancer diagnosis can bring many difficult decisions. One option some women may consider is a mastectomy, a surgery that removes one or both breasts to treat or prevent the spread of cancer. Although the idea of surgery can feel overwhelming, it is often an important step toward protecting long-term health.

Understanding the procedure can make the journey feel less uncertain. By learning about the different types of mastectomy, how to prepare for surgery, and what recovery looks like, patients and their families can feel more informed and confident about the path ahead.

What is Mastectomy Surgery?

A mastectomy is a surgical procedure that removes the entire breast to treat or prevent breast cancer. Unlike breast-conserving surgery, which removes only the tumour and a small amount of surrounding tissue, a mastectomy removes all breast tissue to reduce the risk of cancer remaining or returning. It is often recommended when cancer is widespread or when the risk of recurrence is high. In some cases, people with a high genetic risk, such as BRCA1 or BRCA2 mutations, may also choose a mastectomy as a preventive step to lower their chances of developing breast cancer in the future.

Types of Mastectomy Procedures

There are several types of mastectomy procedures, and each is designed for different medical situations. The type of surgery chosen usually depends on factors such as the size and location of the tumour, whether the cancer has spread, and whether the patient plans to have breast reconstruction.

Each procedure focuses on removing cancer effectively while preserving as much healthy tissue and appearance as possible. Below are the most commonly performed types of mastectomy procedures.

Total (Simple) Mastectomy

A total mastectomy, also known as a simple mastectomy, involves the removal of the entire breast tissue, including the nipple, areola, and most of the breast skin. The goal of this procedure is to completely remove the breast tissue that may contain cancer cells.

However, the lymph nodes in the underarm (axillary lymph nodes) are usually not removed during this surgery, and the chest muscles beneath the breast are left intact. It is often recommended for patients with large areas of ductal carcinoma in situ (DCIS), multiple affected areas in the breast, or individuals choosing preventive surgery due to high cancer risk.

Modified Radical Mastectomy

A modified radical mastectomy is a more extensive procedure compared to a simple mastectomy. In this surgery, the surgeon removes the entire breast tissue along with the nipple and areola, similar to a total mastectomy.

In addition, many of the lymph nodes in the underarm area are removed, a process known as axillary lymph node dissection. This is usually done when the cancer is invasive or there is concern that it may have spread to the lymph nodes, helping doctors determine the stage of cancer and plan further treatments such as chemotherapy or radiation therapy.

Skin-Sparing Mastectomy

A skin-sparing mastectomy is often performed for patients who plan to have immediate breast reconstruction after surgery. In this procedure, the breast tissue, nipple, and areola are removed, but most of the natural breast skin is preserved.

The preserved skin acts as a natural covering for the reconstructed breast, allowing surgeons to place an implant or tissue from another part of the body more easily. This method often provides better cosmetic results, but it is generally recommended only when the cancer has not spread to the skin.

Nipple-Sparing Mastectomy

A nipple-sparing mastectomy is the most cosmetically conservative type of mastectomy. In this procedure, the surgeon removes all the breast tissue while preserving the breast skin, nipple, and areola.

Because the nipple and areola remain, the reconstructed breast can look more natural after surgery. This option is usually suitable for patients with small tumours located away from the nipple or for individuals undergoing preventive mastectomy due to a high genetic risk, although careful evaluation is needed to ensure it is safe.

How Can I Prepare for Mastectomy Surgery?

Preparing for surgery involves getting your body ready and organising your home for recovery. Your surgical team will provide medical instructions, but taking a few simple steps in advance can support better healing and reduce the risk of complications after surgery.

• Quit smoking: Smoking reduces blood flow and oxygen in the body, which can slow down healing after surgery. Stopping smoking before the procedure helps your body recover better and may also improve options for breast reconstruction.
• Follow fasting instructions: Your surgeon will ask you not to eat or drink for several hours before surgery. An empty stomach is important for safe general anaesthesia and helps prevent complications during the procedure.
• Plan your hospital stay: Most mastectomy procedures require at least one night in the hospital. Pack comfortable, loose clothing such as front-opening shirts or button-down tops, and arrange for someone to manage work or home tasks while you are away.
• Arrange help at home: After surgery, you may have limited arm movement and feel tired. It is helpful to have someone stay with you for the first few days to assist with meals, household chores, or getting in and out of bed.

What Happens During the Procedure?

A mastectomy is performed under general anaesthesia, which means you will be asleep during the procedure. The surgical team follows a careful and planned process to remove the breast tissue safely and reduce the risk of complications.

• Preparation and sanitisation: Once you are asleep, the surgical team cleans and sterilises the skin around the breast to reduce the risk of infection. You may also receive antibiotics through an IV.
• Making the incision: The surgeon makes a carefully planned cut (incision) on the breast. The location and size of the cut depend on the type of mastectomy being performed.
• Removing breast tissue: The surgeon then removes the breast tissue. In some cases, the skin, nipple, and areola may also be removed depending on the surgical plan.
• Checking lymph nodes: If needed, the surgeon may remove some lymph nodes from the underarm area. These are tested in a lab to see if cancer cells have spread.
• Breast reconstruction (if planned): If immediate reconstruction is chosen, a plastic surgeon may rebuild the breast shape using an implant or tissue from another part of the body.
• Placing drains: Small tubes called surgical drains may be placed to remove extra fluid from the surgical area. These drains usually stay in place for about one to two weeks.
• Closing the incision: Finally, the surgeon closes the cut using stitches or surgical staples and covers the area with a protective dressing.

How Long Does the Procedure Take?

The length of a mastectomy surgery depends on the type of procedure being performed. A simple mastectomy without reconstruction usually takes about 60 to 90 minutes, while a modified radical mastectomy with lymph node removal may take around two to three hours. If immediate breast reconstruction is done at the same time, the surgery can take four to eight hours, depending on the complexity and whether one or both breasts are being treated.

What are the Risks of This Procedure?

Like any major surgery, a mastectomy can have some risks and complications. Doctors take many precautions to keep patients safe, but it is still important to be aware of possible issues that may occur during recovery.

• Surgical wound infection: This may cause redness, swelling, pain, or discharge around the incision site.
• Hematoma: A collection of blood under the skin that may cause swelling and may sometimes need to be drained by a doctor.
• Seroma: A buildup of clear fluid in the surgical area, which can occur after the drains are removed.
• Flap necrosis: In reconstruction surgeries, the skin or tissue flap may not get enough blood flow, which can cause the tissue to die.
• Lymphedema: Swelling in the arm or hand that can happen after lymph node removal, as it affects the normal drainage of lymph fluid.
• Post-mastectomy pain syndrome (PMPS): Long-term nerve pain in the chest wall, armpit, or arm that continues even after the surgical area has heal

Recovery After Mastectomy

Recovery after a mastectomy takes time and patience. Initial healing usually happens within the first few weeks, but full recovery can take a few months. Following your doctor’s instructions and taking proper care of yourself can help support a smoother recovery.

• Pain management: Some pain or discomfort is normal after surgery. Your doctor will prescribe pain relief medication to help manage it, and it should be taken as directed.
• Drain care: If surgical drains are placed, you will be shown how to empty and measure the fluid. This helps doctors monitor healing and decide when the drains can be removed.
• Movement and exercise: Arm movement may be limited at first. Your doctor may suggest gentle arm exercises to improve mobility, prevent stiffness, and reduce the risk of lymphedema.
• Wound care: Keep the incision area clean and dry. Your healthcare team will guide you on when you can shower and how to care for the dressing.
• Emotional support: It is normal to feel emotional after surgery. Support from counselors, support groups, or loved ones can help during the recovery process.

Wrapping Up

A mastectomy can be an important step in the treatment or prevention of breast cancer. While the thought of surgery may feel overwhelming, understanding the procedure, preparation, possible risks, and recovery process can help patients feel more informed and confident about their decisions.

For NRIs living abroad, surgeries like mastectomy and follow-up care can be very expensive. In comparison, treatment in India is often much more affordable while still offering access to experienced doctors and quality medical facilities. With Niva Bupa NRI Health Insurance, you can plan your treatment in India with greater financial security and peace of mind. 

FAQs

1. Is there a risk of cancer returning after a mastectomy?

   A mastectomy greatly reduces the chance of cancer returning in the same area, but it cannot completely remove the risk. In rare cases, cancer cells may come back in the skin or chest wall. Regular follow-up check-ups and physical exams are important to monitor your health.

    

2. Are mammograms needed after a mastectomy?

   After a total mastectomy, mammograms are usually not needed on the treated side because most of the breast tissue has been removed. However, if only one breast was removed, regular mammograms for the remaining breast should continue as recommended by your doctor.

    

3. What if I do not want breast reconstruction?

   If you choose not to have reconstruction surgery, you can use an external breast prosthesis (breast form). These are specially designed forms that fit inside a bra and help create a natural body shape. They are usually fitted six to eight weeks after surgery, once swelling has reduced.

    

4. Will I notice changes in sensation after surgery?

   Yes, numbness in the chest, underarm, or upper arm is common after a mastectomy because small nerves may be affected during surgery. Some feeling may gradually return over time, but mild numbness can sometimes be permanent.