Mastectomy and the Recovery Process

When Is a Mastectomy Recommended?

Mastectomy is recommended under several circumstances, including but not limited to:

• Breast Cancer Treatment: It is a common treatment for those diagnosed with breast cancer, especially if the cancer is not considered suitable for breast-conserving surgery (lumpectomy), has spread to multiple areas in the breast, or has recurred.
• Preventive Measure: Individuals at high risk of developing breast cancer, such as those with BRCA1 or BRCA2 gene mutations, may choose to undergo a mastectomy to reduce their risk.
• Next Step After Other Treatment: For some, mastectomy may be recommended after less invasive treatments, like lumpectomy combined with radiation therapy, have not been successful in eliminating cancer.
• Patient Preference: Some individuals opt for a mastectomy over other treatments for personal reasons, including peace of mind or to avoid prolonged treatments.

What Are the Types of Mastectomies?

Mastectomy procedures vary depending on the extent of breast tissue removal, preservation of the skin and nipple, and whether breast cancer surgery is performed as a treatment or preventive measure. Here are the most common types of mastectomy:

• Standard (Total) Mastectomy

  In a simple mastectomy, the entire breast tissue is removed, but the muscle tissues beneath the breast are left intact. This procedure is often recommended for patients with multiple or large areas of ductal carcinoma in situ (DCIS) and those seeking prophylactic treatment.
• Skin-sparing Mastectomy

  This surgery involves removing all the breast tissue, including the nipple and areola, but preserving most of the breast skin. Individuals planning immediate breast reconstruction often opt for this procedure as it allows for a more natural-looking reconstruction.
• Nipple-sparing Mastectomy

  A nipple-sparing mastectomy preserves the breast skin, nipple, and areola while removing the breast tissue, offering a natural look after reconstruction with similar effectiveness to traditional surgery. Patients with early-stage cancer located away from the nipple are suitable candidates.
• Modified Radical Mastectomy

  This type involves removing the entire breast along with most underarm (axillary) lymph nodes. The chest muscles are left intact. A modified radical mastectomy is generally recommended for treating invasive breast cancer.
• Radical Mastectomy

  A radical mastectomy is the most extensive form of mastectomy and involves the removal of the whole breast, axillary lymph nodes, and the chest wall muscles under the breast. Nowadays, this procedure is usually only performed when the breast cancer has spread to the chest muscles.
• Prophylactic Mastectomy

  Also known as preventive mastectomy, this surgery is performed to remove one or both breasts to reduce the risk of developing breast cancer. It is often considered by those with a high genetic or familial risk.
• Contralateral Prophylactic Mastectomy

  This preventive surgery involves removing the healthy breast in patients who have cancer in the other breast. It is performed to reduce the risk of developing breast cancer in the healthy breast, particularly for women at very high risk.

How Is a Mastectomy Done?

Mastectomy is performed under general anaesthesia, where the surgeon removes breast tissue through incisions on the breast. Here is generally how a mastectomy is done:

• Before the Procedure

  Patients undergo comprehensive medical evaluations, including imaging tests and consultations, to determine the specifics of their surgery. Genetic testing may be recommended for those with a family history of breast cancer. Patients will receive instructions on preparing for surgery, such as fasting and medication adjustments.
• During the Procedure

  The surgery is performed under general anaesthesia. The surgeon makes an incision in the breast to remove breast tissue and possibly lymph nodes if the cancer has spread. The method of incision and extent of tissue removal varies based on the type of mastectomy and whether immediate reconstruction is chosen. The removed tissue will be examined in a lab, and drainage tubes will be inserted into the operative site to drain any fluids after surgery.
• After the Procedure

  Patients will be taken to a recovery room for monitoring and to check for post-operative pain. After a 1–2-day hospital stay, patients will be discharged and continue recovery at home.

What Are the Risks of a Mastectomy?

While a mastectomy is a commonly performed and generally safe surgery for the treatment or prevention of breast cancer, patients should be aware of the following risks:

• Infection: The surgical site can become infected, requiring antibiotics or additional treatment.
• Bleeding: There is a risk of bleeding during or after the surgery, which might necessitate a blood transfusion or additional surgery.
• Pain and Swelling: Post-surgical pain and swelling are common but usually improve with time and can be managed with medication.
• Scarring: Scarring is inevitable with any surgery, and the appearance and extent of scars depend on the individual's healing process and the type of mastectomy performed.
• Changes in Sensation: Patients may experience changes in sensation around the surgery area, including numbness or sensitivity, which could be temporary or permanent.

Home Recovery from Mastectomy

Recovery from a mastectomy involves both physical healing and emotional adjustment, with several stages that require careful monitoring and self-care for successful healing. It is crucial to follow the surgeon’s advice on wound care, drain management (if applicable), and gradually increasing activities.

Key Takeaways

Undergoing a mastectomy is a crucial step in treating or preventing breast cancer, requiring clinical expertise along with emotional and psychological support. It affects not just physical health but also a person’s outlook. Thanks to advanced surgical techniques and comprehensive care, patients can look forward to a future where health and quality of life are a priority.

If you or someone you know is considering a mastectomy, you are not alone. Contact Maven Surgery to schedule a consultation with a breast cancer specialist in Singapore. We will discuss your options, address your concerns, and tailor the proper treatment plan to your health goals and lifestyle. Contact us today at 6355 5285 for a supportive and informed surgery journey.

Doctor Profile

Dr Chong Chee Keong

Medical Director & Breast Cancer Surgeon MBBS (Singapore), FRCSEd, FRCS (Glas)

Dr Chong Chee Keong has dedicated his career to treating and managing breast conditions, particularly breast cancer, with a focus on breast surgery. His emphasis on treating breast cancer patients led to the establishment of Maven Surgery. His expertise includes advanced mastectomy techniques, post-operative care, and reconstruction options. By applying modern techniques with compassionate patient care, Dr Chong crafts personalised treatment plans for each patient.