Mastectomy

A mastectomy is a surgery that removes the entire breast. A mastectomy is a treatment option for women who have breast cancer or those who do not wish to have a lumpectomy. In addition, many women who are in a high-risk group elect to have a prophylactic mastectomy, which is a preventive surgery that removes a normal breast to prevent the occurrence of breast cancer.

It is important to remember that after a mastectomy, women no longer require imaging (i.e. sonograms, mammograms, MRI), as the breast tissue has been removed. There are different types of mastectomy surgeries, and your surgeon will consult with you about your options.

Nipple-Sparing Mastectomy

With a nipple-sparing mastectomy, a woman’s existing, natural nipple and areola are preserved. The obvious advantage is the aesthetic benefit, as no further surgery is required to reconstruct the nipple-areola complex. A common misconception is that leaving the nipple-areola complex increases the chance of cancer recurrence, but this is false. Research reveals, in the appropriately selected patient, there is no increase in cancer recurrence in patients who have had nipple-sparing mastectomy compared to patients who have undergone a traditional mastectomy.

There are some limitations to a nipple-sparing mastectomy, the first of which is that not all women are candidates. It may not be the right surgical option for large cancers or those occurring near the nipple. Since all the ducts terminate at the nipple, the nipple is considered part of the breast and therefore is usually removed when the cancer is it near that structure. Women with very large or ptotic (sagging) breasts may not be ideal candidates. When considering this treatment, you should be aware that there may be a loss of sensation or altered appearance of the nipple areola complex.

Skin-Sparing Mastectomy

A skin-sparing mastectomy is a technique to save the breast skin while removing all the underlying breast tissue and nipple. The preserved skin structure provides a good shape and form for implant or flap (autologous) reconstruction. This type of mastectomy is one of the more favorable options due to the natural look, feel, and aesthetic results in immediate breast reconstruction – performed in the same surgery as the mastectomy.

Contralateral Prophylactic Mastectomy

Choosing to have a mastectomy can be a very emotional and difficult decision for many women. For women considering mastectomy of a breast affected by cancer, the question often comes up as to what should be done with the other breast. You may elect to have one breast (unilateral mastectomy) or both breasts removed (bilateral mastectomy). Some women with breast cancer in one breast will choose to have the opposite healthy breast removed in what is called a “contralateral prophylactic mastectomy” (CPM).

© Neil Tanna MD. All rights reserved.

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