Mastectomy: 10 Things to Know

A mastectomy
is the removal of part or the entire breast. It may also involve removing
nearby tissues and lymph nodes. The type of mastectomy a woman needs
depends on the stage and type of breast cancer, and her preference. One of the most
important things to know if you or a loved one is facing breast cancer surgery is
there are different types of mastectomy, from nipple-sparing mastectomy to
radical mastectomy. Learn about mastectomy options, breast reconstruction, risks,
and recovery.

It’s a common
treatment for breast cancer, but mastectomy may also be prophylactic for women
at high risk of developing breast cancer. This includes women with a strong
family history of breast cancer and those who test positive for a gene
mutation, such as mutation of the BRCA1 or BRCA2 genes. Prophylactic
mastectomy will greatly reduce—but not eliminate—the risk of breast cancer. The
extent of surgery can make a difference in how much you reduce your risk.

The type of mastectomy you need depends on the stage and
type of your breast cancer. The greater the spread of cancer cells, the more
breast and nearby tissue the surgeon will remove. Partial mastectomy—known as a
lumpectomy—removes the cancer and a small area of normal breast tissue around
it. Radical mastectomy removes the entire breast, including breast tissue,
nipple, areola, skin, underarm lymph nodes, and the chest wall muscles under
the breast. Talk with your surgeon about these as well as nipple-sparing
mastectomy, simple mastectomy, and a modified radical mastectomy.

A general surgeon specializes in the surgical treatment of a
wide variety of diseases, disorders and conditions. Some general surgeons
specialize in the treatment of patients with breast disease. They may use the
term breast surgeon. Depending on the extent of surgery, the surgeon may send
you home the same day, or you may spend a few days in the hospital. Mastectomy
is performed with general anesthesia.

Most
mastectomies have good outcomes, but it is possible to have a reaction
to the anesthesia, bleeding, blood clots, and infections. This is true of any
surgery. Potential complications of a mastectomy include organ or nerve damage,
scarring problems, and lymphedema. Lymphedema is severe swelling of the arm
that can occur after mastectomy that removes lymph nodes. Talk with your
surgeon about your specific risks and how to reduce them.

Your age, health, and type of surgery you have factor into
your recovery time. It’s a gradual process. It will probably be several weeks
before you're feeling back to normal. Full recovery can take 4 to 8 weeks. Having
breast reconstruction at the same time may lengthen your recovery period.

Breast reconstruction rebuilds the breast mound to the size
and shape it was before mastectomy. It may also involve recreating a nipple and
areola. It’s a great option, but it isn’t right for every woman. It’s a very
personal decision that involves many emotional issues. But there’s no rush to
make it. There are other options—such as special bras and prostheses—that can
restore the appearance of a normal bust line under clothing. Some women choose to live “breast free.” These options offer women the flexibility of
having reconstruction in the future if they want it.

Some women struggle with their identity as a woman after
mastectomy. You may feel a sense of loss over your femininity or sexuality. It
may take time to process your feelings about the effects of your mastectomy. It will also take some time to adjust
to a reconstructed breast if that’s what you choose. Many women find comfort in
talking with therapists, support groups, and friends and family about the
emotional aspects of a mastectomy.

Losing your breast to cancer can lower your libido and
change how you feel about your body. Talk with your partner about your fears
and concerns. Remember that sex is both a physical and an emotional experience.
Talk with your partner about your desires and how you can boost your emotional
connection. You can enhance your relationship if you make decisions about your
post-surgery sex life together.

This is the
case regardless of the type of mastectomy. This may include regular breast
exams and mammograms after a mastectomy if any breast tissue remains. Removing
both breasts greatly reduces, but does not eliminate, the risk of breast cancer
developing or recurring.

A second opinion can give you additional options that you hadn’t considered or it can reinforce your current decision. It can increase your confidence in your treatment so you aren’t left wondering if you made the right decision. A good doctor understands the value of a second opinion and should encourage you to get one. Some insurance companies even require them. Your doctor can refer you to another breast surgeon or plastic surgeon to discuss your mastectomy and reconstruction options. You can also search Healthgrades.com for breast surgeons and plastic surgeons near you.