A mastectomy is a surgical procedure to remove all of a breast tissue, and in certain cancers can be skin or nipple sparing with immediate reconstruction of the breast.

Mastectomy may be recommended for various reasons, including:

Breast cancer: Mastectomy is commonly performed as part of the treatment for breast cancer. It may be recommended when the tumour is large, located in multiple areas of the breast, or when the patient chooses mastectomy over breast-conserving surgery.

Risk reduction: In individuals with a high risk of developing breast cancer due to strong family history and/or genetic mutations (such as BRCA1 or BRCA2 mutations), a mastectomy may be recommended as a preventive measure to reduce the risk of developing breast cancer in the future.

Treatment of non-cancerous breast conditions: Mastectomy may be performed to treat certain non-cancerous breast conditions, such as severe cases of fibroadenomas or phyllodes tumours or severe gynecomastia in men.

Total (simple) mastectomy: Removal of the entire breast tissue, including the nipple and areola complex, but leaving the chest muscles intact.

Skin-sparing mastectomy: Removal of the breast tissue, nipple and areolar complex, while preserving the breast skin. This allows for better cosmetic outcomes when combined with immediate breast reconstruction [including expander].

Nipple-sparing mastectomy: Removal of the breast tissue, while preserving the breast skin, nipple, and areola. This technique is often used for prophylactic mastectomy or in selected cases of breast cancer.

Breast Reconstruction: After mastectomy, some patients may choose to undergo breast reconstruction to restore the appearance of the breast. Reconstruction can be performed using breast implants, tissue expanders followed by implants, or autologous tissue (using tissue from other parts of the body, such as the abdomen or back).

Sentinel Lymph Node Biopsy: In addition to removing the tumour, a sentinel lymph node biopsy during breast-conserving surgery may be performed to assess whether cancer has spread to the draining ‘gate-keeper’ lymph nodes. This involves identifying and removing one or more sentinel lymph nodes, which are the first lymph nodes to which cancer cells are likely to spread.

Recovery after mastectomy varies depending on the type of surgery performed, individual factors, and whether breast reconstruction is done at the same time [immediate reconstruction]. You will be admitted to the ward for drain tube monitoring, pain medication and rest after your surgery.

Following mastectomy for breast cancer, patients may receive additional treatments such as radiation therapy, chemotherapy, hormone therapy, or targeted therapy to reduce the risk of cancer recurrence and improve outcomes.

After mastectomy, patients require regular follow-up appointments with their surgeon for a minimum period of 5 years to monitor for any signs of cancer recurrence, assess the healing process, and address any concerns related to breast reconstruction or post-operative recovery.

This will including annual imaging and clinical assessment of the breasts by your surgeon.

Mastectomy can have significant psychological and emotional effects on patients, including body image concerns, grief over the loss of the breast, and fear of cancer recurrence. Support from healthcare providers, counsellors, and support groups can be beneficial for coping with these emotional challenges.