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Modified Radical Mastectomy (Breast Removal)

A modified radical mastectomy is a procedure in which the doctor removes your breast and the lymph nodes in your armpit.

When is it used?

This procedure is one of the choices for surgical treatment when invasive cancer is found in the breast.

Modified radical mastectomy is the first treatment choice when a cancer is too large to be removed without removing all of the breast. Sometimes a large cancer may shrink with chemotherapy so it can be removed without removing all of the breast (local removal). Talk with your health care provider about this possibility. Examples of other surgical treatments are:

You should ask your surgeon about these choices. Take notes as you talk since there are many possible combinations of surgical treatment. Also, it is helpful to have a family member or friend listen to the choices with you.

Other treatments used with surgery are:

How do I prepare for a modified radical mastectomy?

Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties. Ask your health care provider if there is a breast cancer support group you could contact. This group can help you find and talk with other women who have had a mastectomy.

Follow your health care provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Tell your health care provider if you take aspirin or any medicine with aspirin in it. Stop these medicines at least a week before surgery.

Follow any other instructions your provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight or the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You are given a general anesthetic. A general anesthetic relaxes your muscles, puts you to sleep, and prevents you from feeling pain.

The surgeon makes a cut over the breast and lifts the skin away from the breast tissue. The surgeon separates this tissue, including the nipple, from the muscle that lies between the breast and rib cage. Once the surgeon has removed the breast and tissue around it, the skin flaps are sewn in place and a tube is temporarily put under them to drain fluid. If the breast is rebuilt, these skin flaps are used in the reconstruction.

The surgeon also removes tissue under the armpit. This tissue contains lymph nodes that may also have cancer. Ask your surgeon if you are a candidate for sentinel lymph node biopsy. If you have a full axillary dissection, the nerves that provide feeling to the underside of the upper arm may be removed or injured.

What happens after the procedure?

What are the benefits of this procedure?

It may provide your best chance to survive breast cancer.

What are the risks associated with this procedure?

There are some risks when you have general anesthesia. Discuss these risks with your doctor.

• Fluid may collect under the skin flaps after your drains are removed. The surgeon will remove the fluid with a needle and syringe.
• Nerves in the area of the surgery are damaged. As a result, the underside of your arm may be numb. After the surgery you may have trouble moving some of your shoulder muscles because of tenderness. Special exercises will help you regain normal movement of your shoulder.
• You may develop arm swelling, called lymphedema. This is caused by interference with normal lymph drainage from the arm. Surgery alone usually does not cause this condition. It can occur when you have a mild infection in the arm on the mastectomy side, even years later. Ask your provider about how you can help avoid this problem.
• There is a chance a lumpy scar will develop. This is called a keloid. Tell your provider if you have other scars that have healed this way.
• This procedure may not remove all of the cancer cells and further treatment may be necessary.
• The cancer may recur.
• You may have infection or bleeding.

You should ask your doctor how these risks apply to you.

When should I call the doctor?

Call the doctor immediately if:

• You develop a fever.
• The area of the incision is red.
• You have unusual drainage from the incision.
• You have pain that gets worse.
• Fluid collects under the skin flaps.

Call the doctor during office hours if:

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Updated 9/05

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Developed by McKesson Health Solutions LLC.
Published by McKesson Health Solutions LLC.
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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