What Is a Mastectomy? A Breast Cancer Surgeon Explains

Depending on your risk factors, there are different types to choose from.

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“Most women [who] are diagnosed with breast cancer will have surgery at some point during their treatment,” says Jaime Alberty-Oller, MD, breast cancer oncologist and surgeon at the Dubin Breast Center at Mount Sinai Hospital.

One of the primary types of breast cancer surgery is a mastectomy. This surgery is not only used to treat breast cancer, but just as importantly, to help prevent the cancer from returning in the future.

A mastectomy can be summed up as the complete removal of the breasts, but there are different types:

  • A total mastectomy removes all parts of the breast, including the nipple, areola, and skin.

  • A skin-sparing mastectomy removes the breast and nipple while leaving the skin over the breast intact. Then, implants are used to reconstruct the breast, using the woman’s natural skin.

  • A nipple-sparing mastectomy leaves both the skin and the nipple (and areola, the darker area around the nipple) intact. This is typically followed by breast reconstruction surgery.

  • A modified radical mastectomy is a total mastectomy that also removes the axillary lymph nodes, which are the lymph nodes under the arm. This is used when the cancer has spread to the nearby lymph nodes.

In some cases, the type of mastectomy that a woman gets may depend on her personal preference, but often there are certain risk factors that must be considered. For example, if the cancer cells are close to the surface of the skin, a skin-sparing mastectomy might not be safe or appropriate.

Breast cancer surgery is often not done alone. Other cancer therapies—such as hormone therapy,  chemotherapy, radiation therapy, or targeted therapy—can be done either before or after surgery. Usually, when other therapies are used before surgery, the goal is to shrink the tumor so that a woman can get a lumpectomy instead of a mastectomy. (Learn more about the difference between lumpectomy and mastectomy here.)

Alternatively, using other cancer therapies after surgery can help eliminate any cancer cells that may have spread beyond the breasts and reduce the risk of recurrence.

“The most important thing is to get the cancer out, and do a surgery that is safe, oncologically speaking,” says Dr. Alberty-Oller.

Planning on receiving a mastectomy?