A nipple-sparing mastectomy is a skin-sparing mastectomy that also preserves the nipple and areola. Some women choose to have breast reconstruction to help restore the look of the breast that was removed. Reconstruction may be done at the same time as the mastectomy immediate or later delayed. In general, cosmetic results are better with immediate reconstruction. Not all women choose to have reconstructive surgery.
Some women choose to get a breast prosthesis. Learn more about breast reconstruction. Learn about insurance coverage and financial assistance for breast reconstruction. The surgeon will leave the area as flat as possible so the prosthesis can be comfortably fitted to your chest. Your health care provider can discuss breast prosthesis options with you and help you choose the type that best fits your lifestyle. Learn about insurance coverage for breast prosthesis and financial assistance for breast prosthesis.
Susan G. Learn about TSA screening if you wear a wig, scarf or other head covering. Learn about TSA screening if you wear a compression sleeve. If you have concerns about airline security screening, visit the TSA website. However, in some cases, radiation therapy is used after a mastectomy to treat the chest wall, the lymph nodes in the underarm area axillary nodes and the lymph nodes around the collarbone. If your treatment plan includes chemotherapy, you will have radiation therapy after you finish chemotherapy.
Some women can have a lumpectomy plus radiation therapy instead of a mastectomy. For example, those who have tested positive for a breast cancer BRCA gene change are at very high risk. These high-risk women often have their breasts removed before they get breast cancer. This is called a preventive or prophylactic mastectomy. It can greatly lower their risk of cancer. Having cancer in one breast does not put a woman in this very high-risk group. Your doctor can help you understand your own personal risk of a new cancer and the best way to manage that risk.
Some surgeons may not agree to remove both breasts unless a woman is at high risk of a second breast cancer. Insurance companies that offer mastectomy coverage must also provide coverage for reconstructive surgery after mastectomy. But there is a chance they may not pay to remove or reconstruct a breast that does not have cancer.
Most women are satisfied with the results of the surgery, but some women regret having it. Some find that having their breasts removed affects how they feel about themselves. And they may not gain the peace of mind they had hoped for.
In general, women are more satisfied when they feel well-informed and take an active role in this decision. Be sure to give yourself time to think through both the medical facts and how you feel about your choices. This is a very personal decision. Your feelings are as important as any other factor. No one else can tell you what's right for you. But it may help to discuss your choices with people who know you well.
If you're thinking about breast reconstruction, it's a good idea to meet with a plastic surgeon. You can ask to see photos and talk to women who have had the surgery. Author: Healthwise Staff.
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous nipple-sparing mastectomy.
Simple Mastectomy Larger Version. A simple or total mastectomy is appropriate for women with multiple or large areas of ductal carcinoma in situ DCIS and for women seeking prophylactic mastectomies — that is, breast removal in order to prevent any possibility of breast cancer occurring.
Modified radical mastectomy Larger Version. Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. The amount of pain you have will vary. It depends on the amount and location of tissue removed during surgery. Most soreness may last a few days.
Take a pain reliever as advised by your doctor. Aspirin and some other pain medicines may increase your chance of bleeding. Be sure to take only recommended medicines. If lymph node removal dissection was done with your mastectomy, your doctor may want you to do certain exercises. These can help limber up your shoulder and arm area, and help prevent swelling. Soreness after lymph node removal may cause you to keep your arm and shoulder very still.
This can make your arm and shoulder stiff. But overdoing the exercises can also hurt you. So start the exercises slowly. Do them regularly, and progress a little each day. In the meantime, avoid doing anything strenuous. Your doctor will tell you when you can start driving again and when you can go back to work. If you have problems dealing with your recovery, your doctor may refer you to a volunteer agency or group for support.
Removing lymph nodes may affect how lymphatic fluid drains from your arm, neck, and chest on the affected side. Problems with lymphatic drainage can cause swelling in your arm. You may also be at greater risk for infection from injury to your arm.
And there is a higher risk for blood clots in your armpit veins after surgery to the area. You will have to follow certain safety steps for the rest of your life after lymph node removal. This will help prevent problems in the affected arm. These safety steps include:. Patients undergoing mastectomy may have concerns about the appearance of their breast s after the procedure.
Fortunately, breast reconstruction is possible for the majority of patients after mastectomy. Your doctor will discuss with you your options regarding reconstructive surgery. Alternative solutions to reconstruction after mastectomy include the use of an external prosthesis or a special mastectomy bra. Often, patients who need a mastectomy may undergo breast reconstruction surgery during the same procedure. One advantage to immediate breast reconstruction is waking up with the beginnings of a breast mound already in place.
A disadvantage is having to consider reconstruction options during an already stressful time prior to surgery for cancer. Additionally, if there is a recurrence of the cancer, the reconstruction may need to be modified. Postsurgical complications could also call for additional surgeries. Small revision surgeries or matching procedures on the opposing breast are often required.
An alternative solution to immediate reconstruction is a staged process, where the surgeon places a temporary tissue expander to gradually stretch the muscle and skin in preparation for an implant or reconstruction.
The overall result can be more symmetrical, natural and aesthetically pleasing. It serves as a placeholder to allow for radiation and any additional cancer treatment to be completed.
Others simply need time to come to terms with losing their breast s. Those women may prefer this reconstructive alternative, which is available after all recommended cancer treatments are completed. Mastectomy Breast Reconstruction Overview.
A mastectomy is the removal of the breast, nipple and areola to treat breast cancer. This video examines the different types of mastectomy surgeries available. Why might I need a mastectomy? A mastectomy may be done as part of treatment for breast cancer. Your doctor will likely advise you to have a mastectomy if: The tumor is large The tumor involves more than 1 area of your breast Using radiation therapy is not advised The size of your breast may also help determine the type of mastectomy that is done.
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