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Breast Cancer Treatment

Surgery: Mastectomy

The standard surgical treatment for breast cancer for the past 30 years has been a modified radical mastectomy (MRM). This involves the complete removal of the breast, along with the thin covering overlying the pectoralis muscles, and most of the lymph nodes located underneath the arm. The incision typically measures 15-20 cm (6-9 inches) and is made in a transverse (side-to-side or horizontal) fashion unless the tumor is located high in the breast. The chest wall muscles are not removed and are left intact. The nipple and areola are removed but most of the skin is left intact.

The chance of the cancer returning at the site where the breast was after this kind of treatment is 2% to 9% at 8 to 10 years after the surgery. Another way to say this is that within 10 years after a modified radical mastectomy for breast cancer, about 2 to 9 women in 100 will have the cancer come back in the area.

For some patients undergoing reconstruction by a plastic surgeon, the procedure can sometimes be performed through a minimal incision (2-3 inches) centered around the nipple-areola complex. This is called a skin sparing mastectomy. The advantage of this technique is that more skin is preserved for possible later reconstruction and the reconstruction looks more natural.

A simple or total mastectomy means that the surgeon will remove the entire breast, but does not remove lymph nodes from underneath the arm. Your doctor may recommend this if you have a non-invasive breast cancer (ductal carcinoma in situ or DCIS). If you have invasive breast cancer, it may be combined with a sentinel lymph node biopsy.

Mastectomy and Plastic Surgery

Breast reconstruction can be performed immediately after mastectomy or in a delayed fashion after any chemotherapy or radiation therapy is performed.

What are the side effects of a mastectomy?

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