Mastectomy: What to Expect

How long surgery takes

Mastectomy with lymph node dissection takes 1 1/2 to 2 hours. The process of being admitted and prepared for surgery will vary from place to place. The amount of time you spend in the recovery room, waking up and getting to the point that you're ready to go home, will vary from woman to woman.

The incision

Most incisions are in the shape of an oval around the nipple, running across the width of the breast.

What happens

Your breast tissue is separated from your overlying skin and from the chest wall muscle underneath. All of the breast tissue—which lies between the collarbone and ribs, from the side of the body to the breastbone in the center—is removed. If you are having a modified radical or full radical mastectomy, some of your chest muscle may be removed as well. Finally, your surgeon checks the area for bleeding, inserts drains, and stitches the wound closed. Dressings are put on the incision site.

• More on post-surgical care

The risks

• Numbness of the skin along the incision site and mild to moderate tenderness of the adjacent area (due to cut nerves). This is very common.
  
  
  
  
• Extra sensitivity to touch within the area of surgery. This is also due to irritated nerve endings. The sensation usually improves as the nerves grow back.
  
  
  
  
• Fluid collecting under the scar. This may be hematoma—an accumulation of blood in the wound—or seroma, an accumulation of clear fluid in the wound. Both usually respond readily to treatment, which may mean that your doctor removes the fluid with a needle.
  
  
  
  
• Delayed wound healing. During mastectomy, the blood vessels that supply your breast tissue are cut. Occasionally that can present problems when your body tries to heal the incision site. If there isn't enough blood flow to the flaps of your incision, small areas of skin may wither and scab or need to be trimmed by your surgeon. This is uncommon and is usually not a serious complication.
  
  
  
  
• Increased risk of infection in the surgical area. This is usually discovered early and responds well to treatment.

The hospital stay

Fifteen or twenty years ago, you could expect a routine hospital stay of two weeks or more following mastectomy. Today, hospital stays average three days or less. If you have a mastectomy and reconstruction at the same time, you may be in the hospital a little longer.