Mastectomy overview

Overview

A mastectomy is surgery to remove all breast tissue from one or both breasts. It is most often done to treat breast cancer or to reduce the risk of breast cancer in people with a very high risk.

Mastectomy is a relatively common procedure for people diagnosed with breast cancer. However, many people with early-stage breast cancer are treated with breast-conserving surgery (lumpectomy) followed by radiation, so mastectomy is not needed for everyone.

It mostly affects women, but men can also have a mastectomy if they develop breast cancer. It may also be considered for people who have a very strong family history of breast cancer or certain genetic mutations.

Symptoms

Common symptoms

• A new lump in the breast or armpit that feels different from the rest of the breast tissue.
• Swelling or thickening of part of the breast.
• Skin changes on the breast, such as dimpling, redness, or scaliness.

Symptoms in children

• Breast cancer in children is extremely rare. Symptoms in such rare cases would be similar to adults, but children may not report changes. Any unusual breast lump in a child should be checked by a doctor.

Symptoms in older adults

• Older adults may have the same symptoms as younger people, but they might also notice nipple changes like discharge or turning inward.

Causes

Main causes

• The main reason for mastectomy is to treat breast cancer.
• It may also be done to prevent breast cancer in people with a very high risk, such as those with BRCA1 or BRCA2 gene mutations or a strong family history.

Risk factors

• Risk factors that make someone more likely to need a mastectomy include having breast cancer, having dense breast tissue, a strong family history of breast cancer, or carrying a genetic mutation that raises breast cancer risk.

When to see a doctor

See a doctor urgently if:

• If you notice a new lump, skin changes like dimpling, or nipple discharge that is new and not from breastfeeding, see a doctor within a few days.

Book a routine appointment if:

• Follow your healthcare provider’s schedule for routine breast exams and mammograms. This helps find problems early.

Diagnosis

Before a mastectomy is recommended, doctors diagnose breast cancer using imaging tests and a biopsy. If cancer is found, they will discuss treatment options, including mastectomy.

Tests that may be done

• Mammogram (a low-dose X-ray of the breast)
• Breast ultrasound
• Biopsy (taking a small sample of breast tissue to check for cancer cells)

What to expect at your appointment

If a lump or change is found, you will have imaging tests first. If those suggest cancer, a biopsy will be done. The results usually come back in a few days. Your doctor will explain what they show and what your options are.

Treatment

Mastectomy is one treatment for breast cancer. Other treatments include lumpectomy (removing only the tumor) followed by radiation, or sometimes chemotherapy, hormone therapy, or targeted therapy. Your healthcare team will recommend a plan based on your specific cancer.

Self-care at home

• Follow your surgeon’s instructions on caring for the incision and drains after surgery.
• Do gentle arm and shoulder exercises as directed to prevent stiffness.
• Ask your healthcare team about resources like support groups or counseling to help with emotional recovery.

Medical treatments

Medical treatments for breast cancer may include surgery (mastectomy or lumpectomy), radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Your doctor will discuss which treatments are best for you based on your cancer type and stage.

When is surgery considered?

Mastectomy is often recommended when the cancer is large, involves more than one area of the breast, or if the person has a high risk of developing a new breast cancer. It may also be chosen by the patient for personal reasons or after considering genetic factors.

Living with this condition

After a mastectomy, you will need time to heal. You may have some pain, swelling, and limited arm movement at first. Over several weeks, you can gradually return to your normal activities. Many people choose to have breast reconstruction, either during the same surgery or later.

Lifestyle tips

• Avoid heavy lifting until your doctor says it is safe.
• Wear soft, loose clothing that does not rub against the incision area.
• Listen to your body – rest when you need to and slowly increase activity.

Diet and exercise

Eat a balanced diet with plenty of protein to help your body heal. Once your doctor clears you, gentle exercises like walking can boost your mood and strength. Focus on gentle shoulder and arm stretches to improve range of motion.

Mental health and emotional wellbeing

Losing a breast can affect how you see your body. It is normal to feel sad, worried, or frustrated. Many people find it helpful to talk to a counselor, join a support group, or connect with others who have had mastectomy.

Prevention

For some people with a very high risk of breast cancer, a preventive (prophylactic) mastectomy can lower the chance of getting breast cancer. For most people, preventing the need for mastectomy focuses on early detection and treatment of breast cancer through regular screenings.

Screening programmes

Regular mammograms and clinical breast exams can detect breast cancer early, when it is more likely to be treated with less extensive surgery like a lumpectomy.

Complications

If left untreated

• If breast cancer is not treated, it can grow and spread to other parts of the body, becoming life-threatening.
• Untreated breast cancer may cause pain, swelling, and open sores in the breast area.

Long-term outlook

Most people who have a mastectomy for early-stage breast cancer do very well. Advances in surgery and reconstruction have improved recovery and quality of life. Your personal outlook depends on the type and stage of your cancer, and your healthcare team will work with you to achieve the best possible result.

Find support

International organisations

• American Cancer Society
• Cancer Research UK

Local organisations

• Ask your hospital’s patient support services · Worldwide

Helplines

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