Mastectomy

What is a mastectomy?

A mastectomy is surgery that removes the breast. It may be performed on one or both breasts, to remove breast tissue in women who have breast cancer or who have a high risk of developing the disease.

A mastectomy is used as a treatment for several different types of breast cancer and for most stages of breast cancer. It is also a preventive step for women at an increased risk of breast cancer.

How does a mastectomy treat breast cancer?

Removing cancerous cells from the body is the best way to stop the cancer spreading and to cure the disease. A mastectomy involves a surgeon removing all of the breast tissue, aiming to remove all of the cancer cells.

Can a mastectomy prevent breast cancer?

Genetic testing can determine if you have certain genetic mutations that mean you have a higher chance of developing breast cancer. Women carrying the BRCA1, BRCA2, p53 and PTEN genes may be offered preventive methods, such as a mastectomy, to greatly reduce their risk. This is called a prophylactic mastectomy.

When is a mastectomy performed?

The following types of breast cancer can be treated with a mastectomy:

• Infiltrating ductal carcinoma
• Infiltrating lobular carcinoma
• Inflammatory breast cancer
• Paget’s disease of the breast
• Triple-negative breast cancer

Mastectomies are usually a treatment option when breast cancer hasn’t spread to other parts of the body.

Are there different types of mastectomies?

There are different types of mastectomies, which will remove either a part or all of the breast tissue. Today, advances in surgical techniques mean that better preservation of breast tissue is possible, and scars are minimized in ways that were not possible before. These surgical advances are helping women to recover both physically and emotionally from their cancer journey.

The name of the mastectomy usually refers to how much breast tissue is removed.

• Partial mastectomy: Also called a lumpectomy, this involves removing a tumor from the breast, as well as some healthy tissue that surrounds it. It is a treatment option for early-stage breast cancer.
• Total mastectomy: Also called a simple mastectomy, this involves removing all of the breast tissue but leaving the pectoral muscles. A unilateral (one breast) or bilateral (both breasts) total mastectomy may be performed.
• Double mastectomy: Also called a bilateral mastectomy, this involves removing both breasts. It is usually performed when cancer is present in both breasts or when someone has been identified as high risk for the disease developing in both breasts.
• Nipple-sparing mastectomy: This surgery removes the breast tissue but spares the nipple so it can be used during reconstruction.
• Skin-sparing mastectomy: This surgery removes the breast tissue but spares the skin so it can be used during reconstruction.
• Mastectomy with breast reconstruction: Breast reconstruction is sometimes possible at the same time as a mastectomy, depending on the type of breast cancer and treatment plan.
• Modified radical mastectomy: This surgery removes all the breast tissue and the lymph nodes under the arm on the same side.
• Radical mastectomy: This type of mastectomy removes all the breast tissue, as well as the lymph nodes and pectoral muscles.

The type of mastectomy offered will depend on many different factors including the type of breast cancer you have, how advanced it is, and personal preferences. A mastectomy can be an emotional and very personal journey, so your healthcare team will offer support and involve you in the decision-making process.

What happens after a mastectomy?

After a mastectomy, reconstructive surgery may be offered to reconstruct the breast. Surgeons aim to restore the shape, appearance, and symmetry of the breasts. Advanced surgical techniques now offer greater aesthetic results than ever before, an important part of supporting self-image and quality of life for women.

Breast reconstruction can be performed at the time of mastectomy or after cancer treatment has finished. The missing breast can be recreated and rebuilt with either prosthetic reconstructions (implants) or via a more complex microsurgical reconstruction technique called autologous reconstruction. This technique uses the patient’s own tissue to rebuild the breast.

Cleveland Clinic Abu Dhabi was one of the first centers in the UAE to offer the DIEP flap, a specific type of autologous reconstruction using tissue from the lower abdomen. This is the gold standard treatment for breast reconstruction and can include secondary procedures such as fat transfer to the breast and nipple reconstruction.

Cleveland Clinic Abu Dhabi also offers immediate lymphatic reconstruction following surgery, a procedure that can decrease the chance of lymphedema. Only performed at a handful of centers worldwide, prophylactic lymphovenous anastomosis is a cutting-edge surgical procedure which helps to prevent post-surgery swelling and fluid build-up in the upper extremities.

Learn more about reconstructive surgery options here.

 

Breast Health & Cancer

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