A mastectomy is an operation done to remove the entire breast as treatment for breast cancer. A mastectomy involves the removal of all the breast tissue, the nipple and the lymph nodes. A mastectomy may also be preventative, done for those with a high risk of developing breast cancer. This is known as a prophylactic mastectomy.
A mastectomy is generally advised for those with early-stage as well as locally advanced breast cancer after chemotherapy. A mastectomy may be done to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy). Depending on your specific treatment plan, chemotherapy and radiation therapy may form part of treatment prior to or after surgery.
Before having a mastectomy you will have the opportunity to discuss the operation with your surgeon, Dr Heyns. He will explain the different types of mastectomies which include:
A radical mastectomythis involves the complete removal of the breast, including the nipple, the overlying skin, the muscles beneath the breast and the lymph nodes.
A modified radical mastectomythis involves removing the entire breast along with the lymph nodes, leaving the chest muscles and possibly the overlying skin intact. This means a breast reconstruction can be done afterward.
A skin-sparing mastectomywith this type your surgeon will remove all the breast tissue, the nipple, and the areola while saving most of the skin over the breast. A breast reconstruction is then also possible afterwards.
A nipple-sparing mastectomyhere the breast tissue is removed, cutting under and around the nipple and areola, leaving the skin of them intact. This method also calls for reconstruction right after the mastectomy.
The type of surgery recommended for you will depend on things such as how much the cancer has spread. Depending on your specific case, he will provide you with the information needed to make a decision.
All types of mastectomy use general anaesthesia and involve making an incision either diagonally or horizontally across your breast so that the breast tissue can be removed. Thereafter, depending on the type of surgery, the breast tissue is removed.
After your breast has been removed, you may choose to have a breast reconstruction. This is done by a plastic surgeon accompanying Dr Heyns and involves creating an artificial breast to replace the breast or breasts that have been removed. It is sometimes possible for a breast reconstruction to be carried out at the same time as a mastectomy, but it can be delayed until a later date if necessary.
A mastectomy is a rather serious procedure with physical and emotional side-effects. After surgery you will be kept for observation in hospital for the next day or two. During this time you can expect pain in your chest and under your arm. Pain relievers will be prescribed to make you comfortable. Before being discharged Dr Heyns will instruct you on how best to care for yourself and restrictions of movement. If you have had a breast reconstruction done your plastic surgeon will also see you to discuss these aspects. You will need to rest for the next 2-3 weeks.