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Cancer Treatment Centers of America

Mastectomy and breast reconstructive surgery for breast cancer patients

What is a mastectomy?

A mastectomy involves the surgical removal of all the breast tissue. If breast conservation therapy is not a viable option for you, your surgeon may recommend mastectomy. Women who have cancer in multiple areas of the breast and/or large tumors relative to the size of the breast are typically recommended to undergo a mastectomy. Women with certain genetic mutations (BRCA1 or BRCA2) may also be recommended for a mastectomy.

In many instances, much of the breast skin and even the nipple may be spared to improve the outcome of reconstruction. There are several different types of mastectomy:

  • Nipple-sparing mastectomy, where only the breast tissue is removed
  • Skin-sparing mastectomy, where the breast tissue is removed with the nipple and areola
  • Total (simple) mastectomy, where the breast tissue and skin are removed
  • Modified radical mastectomy, where the whole breast is removed, along with the lymph nodes under the arm

Factors such as breast size, breast shape, type of cancer and the location of cancer in the breast and/or lymph nodes will determine which type of mastectomy is performed. Your breast surgeon will guide you through the decision-making process.

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What is breast reconstructive surgery?

Breast reconstruction is a surgical process to recreate the breast shape, volume and contour after a mastectomy. The goal of breast reconstruction is to rebuild and reshape the breast so that it looks and feels as natural as possible. In most cases, your reconstructive surgeon will begin that process at the time of mastectomy. Breast reconstruction usually requires more than one surgery, but in certain cases, the procedure may be completed in one operation. Surgery on the other breast may also be performed to create or improve symmetry.

Various breast reconstruction techniques are available, all of which fall into two basic categories:

  • Implant-based reconstruction, which uses a gel implant with or without a tissue expander
  • Autologous reconstruction, which uses the patient’s own tissue in the form of a flap or graft

Many factors are taken into consideration for each technique. Your reconstructive surgeon will evaluate these factors and guide you through the decision-making process.

Meeting your individual needs

Not all women choose to undergo breast reconstruction, and not all women are candidates for breast reconstruction. Determining if and when to begin reconstruction is an individual decision made by the patient and her care team. Prior to mastectomy, you may meet with one of our plastic surgeons to discuss your reconstructive options.

After the procedure, your care team is also available to support you on many levels. For example, therapies like mind-body medicine may help you cope with the emotional and psychological impact of a mastectomy, and image enhancement services may help promote a positive self-image.