Types of Mastectomy
Historically, women had no choices when they were faced with a breast cancer diagnosis, a mastectomy was always performed after this diagnosis.
Today, while we do have options available to us, many breast cancer patients still do have a mastectomy in cases when there is multifocal breast cancer, when the cancer is in several places in the breast, and when there is a very large tumor.
There are actually several forms of mastectomy available today depending on the stage and/or size of your cancer.
Simple or Total Mastectomy
In this procedure the entire breast is removed, but the lymph nodes in the underarm area (axillary lymph nodes) are not. The muscles under your breast remain intact as well. Lymph nodes located in the breast tissue may be removed during surgery. This form of mastectomy is generally used for women with ductal carcinoma in situ (DCIS) and for women who seek prophylactic mastectomies.
Image courtesy of NIH/NCI
Modified Radical Mastectomy
This is the most commonly performed mastectomy procedure today. The entire breast is removed, as well as levels I and II of the axillary (underarm area) lymph nodes.
Image courtesy of NIH/NCI
Radical Mastectomy
This used to be the most commonly performed mastectomy procedure. Today it is rarely performed, because the modified radical mastectomy is just as effective and less disfiguring.
In the radical mastectomy the entire breast, all axillary (underarm) lymph nodes, and the chest wall muscles under the breast are removed. This is only recommended when the cancer has spread to the chest wall muscles under the breast.
Mastectomies are performed in the hospital under general anesthesia and generally take from one and a half to two hours. The incisions are usually in the shape of an oval and run across the width of the breast. The surgeon separates the breast tissue from overlying skin and from the chest wall muscle underneath. All breast tissue lying between the collarbone and ribs, from the side of the body to the breastbone in the center is removed. In a modified radical or full radical mastectomy, some of your chest muscle may be removed as well.
After checking for bleeding, your surgeon will insert drains and stitch the incision closed. The drains are used to collect excess fluid and blood and minimize swelling. You may wish to question your surgeon about drains, proper care of them, and when they will be removed.
Quandrantectomy
In this procedure a quarter of the breast is removed. A secondary procedure may be performed in order to remove some or all of the axillary lymph nodes.
Partial or segmental mastectomy
In this procedure a section of the breast is removed along with a portion of the healthy tissue. The amount of tissue removed is more than what is taken in a lumpectomy however less than some of the other forms of mastectomy.
Image courtesy of NIH/NCI
