Mastectomy Overview

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A mastectomy is a surgery done to remove breast tissue. A number of different mastectomy procedures exist, including:

• Partial mastectomy or lumpectomy—a tumor and a small margin of surrounding breast tissue is removed
• Simple mastectomy—the entire breast is removed
• Modified radical mastectomy—entire breast and some lymph nodes in the armpit are removed, but chest muscles are left in place
• Radical mastectomy—entire breast, lymph nodes, and chest muscle are removed (rarely done)

Mastectomy © 2009 Nucleus Medical Media, Inc.

Prior to Procedure

Your doctor may do the following:

• Physical exam
• Mammogram —a test that uses low-dose x-rays to make a picture of breast tissue
• Fine needle biopsy of the breast—a thin, hollow needle is used to remove a small tissue sample from the breast
• Blood tests

Leading up to the surgery:

• Talk to your doctor about your medicines and supplements. You may be asked to stop taking some medicines up to one week before the procedure like:

• Aspirin or other anti-inflammatory drugs
• Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
• Arrange for a ride home. Ask someone to help you at home.
• Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be used in most cases. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure

The doctor will make an oval-shaped incision in the breast. The breast tissue, including the nipple and areola, will be removed. This will be done by cutting the tissue off of the underlying muscle. Nearby lymph nodes (toward the underarm) may also be removed. The doctor will then insert a tube to drain blood and fluids. Lastly, the area will be closed with stitches.

How Long Will It Take?

1-3 hours

Will It Hurt?

Anesthesia will prevent pain during the procedure. You may have pain while recovering. You may also have numbness and a pinching or pulling feeling in the underarm area. Your doctor will give you pain medicine to help control this pain. If you are having a small area removed, you may not have much pain.

Average Hospital Stay

1-3 days

Post-procedure Care

At the Hospital

• If you had cancer and it has spread, chemotherapy and/or radiation may be needed.

• The drainage tubes may be removed in 1-2 days.

• Managing pain and nausea—You might require anti-nausea and pain medicines. You may be nauseated for a few hours after surgery and may not be able to eat normally. Therefore, you may continue to receive fluids and sugar through an IV. For several days after surgery, you may need to eat a lighter, blander diet than usual.

• Preventing blood clots—You may be given special compression stockings to wear after surgery. These help to decrease the possibility of blood clots forming in your legs.

• Improving lung function—You may be asked to use an incentive spirometer . This is a device that helps you breathe deeply. It is important to breathe deeply and cough frequently to improve lung function after general anesthesia.

At Home

When you return home, do the following to help ensure a smooth recovery:

• Keep the area clean and dry.
• If you have drainage tubes, empty the drains and measure the fluid. Tell your doctor if you have any problems.
• Avoid vigorous activity for about six weeks.
• Work with a physical therapist. Therapy may involve shoulder and arm exercises.
• Be sure to follow your doctor's instructions .
• If you have had lymph nodes removed, take these precautions to avoid fluid accumulation and infection:

• Elevate the affected arm.
• Perform range of motion activities with the arm. Start slowly.
• Do not have blood pressure taken, blood drawn, or shots given in that arm.
• Wear gloves to do dishes, household scrubbing, and yard work.
• Do not wear anything tight on that arm, including elastic in sleeves.
• Do not carry anything heavy with that arm.
• Use moisturizer on that arm.
• Use an electric shaver to shave your armpits.
• Do not get a sunburn .

Recovery will take about six weeks. You will see your doctor within 7-14 days after the surgery. Your doctor will discuss the results and further treatment. About a month after surgery, you can begin wearing a light-weight prosthetic breast. You can be fitted for a more permanent one when the incision area has healed. If you want breast reconstruction surgery, talk to your doctor.

RESOURCES:

American Cancer Society
http://www.cancer.org/

Breastcancer.org
http://www.breastcancer.org/

CANADIAN RESOURCES:

Canadian Breast Cancer Foundation
http://www.cbcf.org/

Canadian Cancer Society
http://www.cancer.ca/

References:

Axillary lymph nodes. Breastcancer.org website. Available at: http://www.breastcancer.org/pictures/breastanatomy/axillarylymph_nodes.jsp . Updated May 2008. Accessed July 22, 2008.

Surgery for breast cancer. American Cancer Society. Available at: http://www.cancer.org/docroot/CRI/content/CRI244XSurgery_5.asp?sitearea= . Updated September 2007. Accessed July 23, 2008.

Treatments and side effects. Breastcancer.org website. Available at: http://www.breastcancer.org/treatment/ . Updated July 2008. Accessed July 22, 2008.