What is mastectomy?

A mastectomy is a surgical procedure that removes the entire breast primarily to treat breast cancer or to reduce one's risk of breast cancer.

Types of mastectomy

There are several different types of mastectomy, and each is performed based on the amount of breast tissue involved in the surgery:

Standard or total mastectomy

The surgeon removes all of the breast tissue including the nipple, areola, and most of the overlying skin.

Skin-sparing mastectomy

The whole breast, including the nipple is removed, but most of the skin over the breast is preserved. This is typically done together with immediate breast reconstruction.

Nipple-sparing mastectomy

A skin-sparing mastectomy where only the breast tissue is removed, leaving the skin, nipple, and areola intact.

Radical mastectomy

It is a more extensive procedure in which the entire breast, including the skin covering it, the two muscles under the breast, and the axillary (underarm) lymph nodes, are removed. This is done if the cancerous involvement is extensive.

Modified radical mastectomy

The procedure involves the removal of the entire breast. This includes the nipple, the areola, and the overlying skin except for the muscles behind the breast.

Why do you need a mastectomy?

A mastectomy is done to reduce one’s risk of breast cancer (prophylactic mastectomy) and to treat several types of breast cancers such as:

  • Ductal carcinoma in situ (DCIS). This is a type of non-invasive breast cancer that develops in the milk duct and has not spread to the breast tissue.
  • Stages 1, 2 (early-stage) and 3 (locally advanced) breast cancer. Mastectomy is used to treat breast cancer that has not spread to involve other body systems e.g. lung, liver, bones, brain (metastasised).
  • Inflammatory breast cancer. Mastectomy is recommended after chemotherapy as this is an aggressive form of breast cancer.
  • Paget's disease of the breast. A rare type of cancer that affects the skin of the nipple and areola.
  • Locally recurrent breast cancer. This refers to cancer that has returned to the same breast despite breast conserving surgery and radiation treatment.

The procedure may also be done if:

  • Cancer has spread to a large area of the breast and cannot be treated with a lumpectomy (a breast-conserving surgery)
  • An individual (e.g. genetic mutation carrier) has a high lifetime risk of developing breast cancer. In this case, a double mastectomy (removal of both breasts) will be recommended

Who should not go for a mastectomy?

Mastectomy is generally not recommended for women who:

  • Have a known metastatic disease (cancer that spreads from one part to another)

  • Have an advanced disease that requires neoadjuvant therapy (any treatment given for the cancer before the main treatment) to shrink the tumour before surgical resection

What are the risks and complications of a mastectomy?

Although mastectomy is considered a relatively safe procedure, it has a few post-operative side effects, the majority of which are temporary and will resolve with time:

  • Fluid accumulation beneath the surgical wound (seroma). This arises from the raw surgical surfaces but reduces in amounts over time. A drainage tube is typically required for 7 – 14 days to assist with drainage so it does not build up to cause discomfort.
  • Bleeding
  • Wound infection
  • Pain in the shoulder and stiffness
  • Hardness due to scar tissue at the surgical site

Why choose Parkway East Hospital?

At Parkway East Hospital, we serve the community of Singapore’s eastern coast and beyond with pride and dedication. We understand that the cancer recovery journey is a difficult one, and our skilled multidisciplinary teams will take you under our wing and manage your health with compassion and care.

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At Parkway East Hospital, your recovery, functional health and quality of life is important to us. Get access to experienced general surgeons and plastic surgeons who can advise you on the most appropriate treatment with dedication and compassion.

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