Mastectomy is the surgical removal of the entire breast.
Some women have the option of mastectomy or lumpectomy (also called breast-conserving surgery) plus radiation therapy, and choose mastectomy. For other women, mastectomy is the only breast cancer surgery option.
Treatment for breast cancer in women
Mastectomy is an option for women who have:
- Ductal carcinoma in situ (DCIS)
- Invasive breast cancer (non-metastatic)
- Inflammatory breast cancer
- Paget disease of the breast (Paget disease of the nipple)
Mastectomy is also used to treat breast cancer that has recurred (come back) after treatment with lumpectomy plus radiation therapy.
Treatment for breast cancer in men
Mastectomy is the main treatment for breast cancer in men. This is because men have little breast tissue and most tumors in men occur under the nipple.
Learn more about treatment for breast cancer in men.
Types of mastectomy
There are 2 main types of mastectomy: total (simple) and modified radical. Your diagnosis guides the type of mastectomy you will have.
Figure 5.2 below shows the types of mastectomy and describes when each is used.
Total (simple) mastectomy
The surgeon removes the entire breast and the lining of the chest muscle, but no other tissue.
For some women, much of the skin of the breast may be left intact for breast reconstruction (called a skin-sparing mastectomy).
In some cases, the nipple may also be left intact (called a nipple-sparing mastectomy).
A sentinel node biopsy may be done, or no lymph nodes may be removed, depending on the breast cancer.
Total (simple) mastectomy may be used to treat:
Total mastectomy is also used for women at high risk who have prophylactic mastectomy.
Sometimes breast reconstruction is done at the same time as a mastectomy.
Modified radical mastectomy
The surgeon removes the entire breast, the lining of the chest muscles and the lymph nodes in the underarm area (axillary nodes).
Modified radical mastectomy may be used to treat:
Sometimes, breast reconstruction is done at the same time as a mastectomy. This is not done for inflammatory breast cancer.
Skin-sparing mastectomy and nipple-sparing mastectomy
If you are having breast reconstruction at the same time as a mastectomy, the surgeon may be able to use a skin-sparing technique, or possibly a nipple-sparing technique.
A skin-sparing mastectomy removes all of the breast tissue but saves much of the skin of the breast. The plastic surgeon can use this skin as an envelope to help form the reconstructed breast.
A nipple-sparing mastectomy is a skin-sparing mastectomy that also preserves the nipple and areola.
Mastectomy with breast reconstruction
Some women choose to have breast reconstruction to help restore the look of the breast that was removed.
Reconstruction may be done at the same time as the mastectomy (immediate) or later (delayed). In general, cosmetic results are better with immediate reconstruction.
Discuss your reconstruction options with your plastic surgeon before breast surgery.
Not all women choose to have reconstructive surgery. Some women choose to get a breast prosthesis. Others choose to have a flat closure (“go flat”).
Visit the FORCE website for a photo gallery of images of people who have had breast reconstruction after a mastectomy.
Learn more about breast reconstruction.
Learn about insurance coverage and financial assistance for breast reconstruction.
Mastectomy with breast prosthesis
If you don’t want to have breast reconstruction, you can get a breast prosthesis. This is a breast form made of silicone gel, foam or other materials that’s fitted to your chest. It’s usually worn in a specially-designed bra.
The form is placed directly on top of your skin or in the pocket of a special bra.
The surgeon will leave the area as flat as possible so the prosthesis can be comfortably fitted to your chest.
Your prosthesis can be properly fitted several weeks after your mastectomy surgery.
Your health care provider can discuss breast prosthesis options with you and help you choose the type that best fits your lifestyle.
Visit the FORCE website for a photo gallery of images of people after a mastectomy.
Learn about insurance coverage for breast prosthesis and financial assistance for breast prosthesis.
Breast prosthesis and air travel
Susan G. Komen® wants to ensure people who have breast cancer are treated with respect and dignity.
When you travel by air, these steps may be helpful:
Learn about TSA screening if you wear a wig, scarf or other head covering.
Learn about TSA screening if you wear a compression sleeve.
If you have concerns about airline security screening, visit the TSA website.
Mastectomy with a flat closure
If you don’t want to have breast reconstruction or use a breast prosthesis after a mastectomy, you can have a flat closure. This is also called going flat.
With a flat closure, the skin remaining after a mastectomy is tightened and smoothed to flatten out the chest wall as much as possible. However, the area will not be completely flat or smooth. How flat the area will be after surgery varies from person to person. There will also be a scar.
Visit the FORCE website for a photo gallery of images of people after a mastectomy, including photos of people who have gone flat.
Talk with your health care provider about your surgery options. If you choose to go flat, talk with your surgeon before breast surgery.
Read our blog, Despite What Doctors Told Me, I’ve Never Regretted My Decision to Go Flat After a Double Mastectomy.
Most women who have a mastectomy don’t need radiation therapy.
However, in some cases, radiation therapy is used after a mastectomy to treat the chest wall, the lymph nodes in the underarm area (axillary nodes) and the lymph nodes around the collarbone.
If your treatment plan includes chemotherapy, you will have radiation therapy after you finish chemotherapy.
When is a lumpectomy plus radiation therapy an option to a mastectomy?
Some women can have a lumpectomy plus radiation therapy instead of a mastectomy.
Learn about deciding between lumpectomy and mastectomy.
Although the exact treatment for breast cancer varies from person to person, guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.
The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.
In addition, the National Cancer Institute (NCI) has treatment overviews.
Talk with your health care team about which treatment guidelines they use.
Transportation, lodging, child care and elder care assistance
You may not live near the hospital where you’ll have your surgery.
Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.
There are also programs to help you with child and elder care costs.
Learn about transportation, lodging, child care and elder care assistance programs.
SUSAN G. KOMEN® SUPPORT RESOURCES