Types of Mastectomy
There are two surgical ways to treat breast cancer: lumpectomy and mastectomy. Lumpectomy is the removal of only that part of the breast containing the breast cancer. Mastectomy is the removal of the entire breast. In this operation, almost all of the breast tissue is removed in hopes of preventing cancer recurrence. There are four types of this treatment: simple (or total) mastectomy often called skin-sparing, nipple-sparing, modified radical, and radical.
Simple Mastectomy vs Total Mastectomy
In this type, all of the breast tissue is removed. All of the breast tissue is removed along with the nipple and areola. No lymph nodes are sampled and no muscle is removed. This is performed for women with smaller cancers and for prophylactic reasons.
This the most recent evolution of the mastectomy treatment. In this case, all of the breast tissue is removed but the nipple and areola are left behind. The incision for this procedure is surgeon dependent but can be below or above the areola, laterally along the breast, or below the breast along the inframammary fold. This procedure is good for women with smaller cancers, far away from the nipple, and in women with smaller breasts. It is also the ideal scenario for women desiring prophylactic mastectomy to prevent the occurrence of breast cancer.
Modified Radical Mastectomy
In women with advanced cancer, the breast and the lymph nodes under the arm (axillary nodes) must be removed. In addition, the covering over the pectoralis muscle, called fascia, is removed as well. This is most commonly performed in women who have proven cancer within the lymph nodes under their arm. Fortunately, this is less common as cancers are recognized earlier and women are more proactive in their own breast health and cancer detection.
This operation was the original operation used to treat breast cancer and fortunately is rarely necessary in today’s day and age. In this type, the breast, all axillary lymph nodes and the pectoralis major muscle (bench press muscle) are removed. It leaves somewhat of a concave deformity of the chest wall and is reserved for women with aggressive cancer that invades the bench press muscle.
Questions to Ask Your Surgeon
- What type of mastectomy will I need and why?
- Where will my scar be and what will it look like?
- What will my recovery be like?
- Will I have drain tubes and for how long?
- Will I have limitations and restrictions after surgery?
- Will I need physical therapy after my surgery?
- How does my this mastectomy type impact my reconstructive outcome?