Breast surgery - mastectomy

A mastectomy is a common treatment for breast cancer. It’s an operation that involves removing some of or your entire breast. Some people might need the operation in both of their breasts. The aim is to remove the cancerous tissues so that the cancer doesn’t coming back or spread to other parts of your body.

A partial mastectomy removes part of your breast tissue. A total mastectomy removes the cancer, breast tissue, nipple and some of the skin. Sometimes, if the cancer has spread, the muscle beneath the breast will also need to be removed.

Before your mastectomy operation

There might be things that you can do before your mastectomy operation to help you to prepare for your surgery and aid recovery. Your breast surgeon or breast care nurse will talk to you about things you can do beforehand to help you get better. If you smoke, you might be asked to stop to speed up your recovery.

You will also need to fast for a set amount of time before your mastectomy operation. This means you won’t be able to eat or drink anything, usually for six hours before surgery.

Before your operation, your breast surgeon or breast care nurse will talk to you about exactly what’s involved and how you might feel afterwards.

What happens during a mastectomy operation?

There are a few different types of mastectomy, and how the surgery is performed depends on which type you have. The main types are:

• standard mastectomy: all your breast tissue and most of the skin covering your breast is removed
• skin-sparing mastectomy: all your breast tissue and your nipple is removed, but most of your skin is left
• subcutaneous mastectomy: the same as a skin-sparing mastectomy, but your nipple is left
• radical mastectomy: all of your breast tissue and skin is removed, plus the muscles behind your breast and the lymph nodes in your armpit
• modified radical mastectomy: the same as a radical mastectomy, but the muscle behind your breast is left.

Breast removal surgery is usually done under general anaesthetic. Because you’ll be asleep, you won’t feel any pain during the operation. Once you’re asleep, your surgeon will make a careful cut (incision) across your breast’s skin so they can remove the cancerous tissue. They will then reshape your skin and neatly close up the incision.

Breast removal surgery usually takes a couple of hours, although it depends on the type of surgery you’re having and whether or not you’re having breast reconstruction surgery in the same operation.

Recovering from breast surgery

Most people are able to go home a couple of days after their mastectomy operation, although it can take three to six weeks to recover completely.

Controlling your pain

When you wake up after your operation, you’ll probably feel sore. You can take painkillers to control any pain so it’s important to tell your breast care nurse if you’re in pain. They can make changes to your medication to make you more comfortable. You may also have a drip attached to your arm until you’re back to eating and drinking.

Preventing infection and swelling

To keep your wound clean and swelling down, you might need a drainage tube to get rid of blood and tissue. You should also keep a dressing place for a few days, although it might be changed so your wound can be cleaned.

Going home

You’ll need plenty of rest when you go home. But you might also be recommended some gentle exercise to help relieve any stiffness in your arm and to improve your circulation.

Side-effects and complications

Mastectomy is a very common treatment for breast cancer, and it’s usually very straightforward without any complications. However, common side-effects after a mastectomy include:

• feeling sore, swollen, bruised or tight around your breast, arm and shoulder
• a scar, which is likely to fade over time
• numbness or tingling in your arm.

If your wound becomes infected, it might look red, become more painful and swollen or leak fluid. If you have a wound infection, you will need to be treated with antibiotics.

If you’ve had any lymph nodes removed, there is a possible risk of developing lymphoedema. This is a condition caused by a build-up of fluid in your arm. It usually happens a few months or years after your surgery, and can make your arm and hand feel swollen, sore or tender. Lymphoedema can be both prevented and controlled as appropriate with treatment.

Making a decision about your breast cancer treatment can be difficult, which is why it’s important to talk about the choices with your breast surgeon and breast care nurse.

Be sure you have all the information you need so you feel prepared to make the right decision for you. It’s also a good idea to talk about your choices with a partner, close friend or family.

Paying for your treatment

You have two options to pay for your treatment – your costs may be covered by your private medical insurance, or you can pay for yourself. Check with your private medical insurer to see if your diagnostic costs are covered under your medical insurance policy.

If you are paying for your own treatment the cost of the procedure will be explained and confirmed in writing when you book the operation.

Ask the hospital for a quote beforehand, and ensure that this includes the consultants’ fees and the hospital charge for your procedure. For further information or to book a consultation or treatment, please get in touch with our cancer enquiries team: Call us on 0800 157 7747

Content reviewed: October 2014