What is Mastectomy?

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" or "total" mastectomy

Simple or total mastectomy concentrates on the breast tissue itself:

• The surgeon removes the entire breast.
• The surgeon does not perform axillary lymph node dissection (removal of lymph nodes in the underarm area). Sometimes, however, lymph nodes are occasionally removed because they happen to be located within the breast tissue taken during surgery.
• No muscles are removed from beneath the breast.

Simple Mastectomy

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Who usually gets simple or total mastectomy?

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

Modified radical mastectomy

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Modified radical mastectomy involves the removal of both breast tissue and lymph nodes:

• The surgeon removes the entire breast.
• Axillary lymph node dissection is performed, during which levels I and II of underarm lymph nodes are removed (B and C in illustration).
• No muscles are removed from beneath the breast.

Who usually gets a modified radical mastectomy?

Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. Examining the lymph nodes helps to identify whether cancer cells may have spread beyond the breast.

Radical mastectomy

Radical mastectomy

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Radical mastectomy is the most extensive type of mastectomy:

• The surgeon removes the entire breast.
• Levels I, II, and III of the underarm lymph nodes are removed (B, C, and D in illustration).
• The surgeon also removes the chest wall muscles under the breast.

Who usually gets a radical mastectomy?

Today, radical mastectomy is recommended only when the breast cancer has spread to the chest muscles under the breast. Although common in the past, radical mastectomy is now rarely performed because in most cases, modified radical mastectomy has proven to be just as effective and less disfiguring.

Partial mastectomy

Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it. While lumpectomy is technically a form of partial mastectomy, more tissue is removed in partial mastectomy than in lumpectomy.

Subcutaneous ("nipple-sparing") mastectomy

During subcutaneous ("nipple-sparing") mastectomy, all of the breast tissue is removed, but the nipple is left alone. Subcutaneous mastectomy is performed less often than simple or total mastectomy because more breast tissue is left behind afterwards that could later develop cancer. Some physicians have also reported that breast reconstruction after subcutaneous mastectomy can result in distortion and possibly numbness of the nipple. Because subcutaneous mastectomy is still an area of controversy among some physicians, your doctor may recommend simple or total mastectomy instead.