A mastectomy is a surgical procedure to remove one or two of the breasts, either completely or partially. There are five different types of mastectomy, including a nipple-sparing mastectomy, a partial mastectomy, a ‘simple’ or total mastectomy, a modified radical mastectomy, and a radical mastectomy.
The main difference between each of the five mastectomies comes down to how much breast tissue is removed during surgery.
What Type of Breast Cancer Requires a Mastectomy?
In general, surgery is the preferred treatment for breast cancer of all types. In the early stages, when few cancerous cells are detected, or a tumor is still small, nipple-sparing or partial mastectomies are performed. However, when breast cancer is more advanced, and the affected area is larger, more extensive surgery is usually required.
Quick Read: Mastectomy Recovery - What to Expect
Can a Mastectomy Prevent Breast Cancer?
Women who are genetically at high risk for developing breast cancer can opt to have a prophylactic or preventative mastectomy. (If you do not know whether you are high risk or not, you can find out through genetic testing.)
This type of mastectomy generally involves removing all breast tissue that could be at risk of developing cancer. The good news is that a preventative mastectomy can reduce the risk of developing cancer by 85%-100% for those at high risk.
What is a Nipple-Sparing Mastectomy?
A nipple-sparing mastectomy (NSM) is recommended when cancer has not spread to the nipple or areola. It is also performed for women with non-inflammatory breast cancer or when breast cancer has not affected the surrounding skin. NSM is also sometimes used as a risk reduction surgery for women who might be prone, genetically, to breast cancer.
The procedure is performed through a small incision, where all glandular tissue is removed from under the nipple and surrounding skin, leaving the nipple completely intact afterward.
What is a Partial Mastectomy?
A partial mastectomy, which is sometimes referred to as a segmental mastectomy, involves removing cancerous or abnormal tissue from the breast, as well as 2-3 centimeters of healthy tissue around it, but not the breast itself. On occasion, some lymph nodes under the arm are also taken for biopsy.
While a lumpectomy could also be referred to as a partial mastectomy, more surrounding tissue is usually removed during partial mastectomy than a lumpectomy.
What is a ‘Simple’ or Total Mastectomy?
A simple or total mastectomy is recommended for women when several or large portions of the cells lining the milk ducts of the breasts have become cancerous. This is considered non-evasive or pre-invasive cancer and is medically referred to as ductal carcinoma in situ (DCIS).
While surgeons remove the entire breast during a simple or total mastectomy, the muscles beneath the breast are not removed. The lymph nodes in the underarm area are not usually removed either, however, in some cases, if the lymph nodes have amalgamated within the breast tissue, they will be removed along with the breast.
What is a Modified Radical Mastectomy?
In general, women suffering from invasive breast cancer will undergo a modified radical mastectomy, which involves removing the entire breast, as well as the first and second level of lymph nodes. The pectoral muscles, or muscles beneath the breasts, are normally spared during a modified radical mastectomy.
What is a Radical Mastectomy?
A radical mastectomy is the most thorough type of mastectomy in that it removes the entire breast, all three levels of lymph nodes, and the pectoral muscles beneath the breast. Historically, this was the most common type of mastectomy. These days, however, it is only recommended if cancerous cells have spread to the chest muscles.
When to See Your Doctor?
It is recommended that all women over the age of 40 should schedule a breast exam, or mammogram, at least once every two years to check for any abnormal cells.
However, if you feel pain, a breast lump, swelling in part of the breast, experience flaky skin around the nipple, discharge from the nipple, or notice anything different about your breasts, don’t hesitate to consult with your doctor for an exam. Catching and treating breast cancer early is the ultimate key to beating it in the long run.
Conclusion
Over 100,000 women undergo a mastectomy in the US each year, providing an important part of breast cancer treatment and a vital prevention procedure for some.
A mastectomy can involve one or two breasts, and partial or complete removal of the breast tissue, depending on what stage of cancerous cells are discovered. Whether and when women have reconstructive surgery after a mastectomy is a personal decision for each woman.
References
Cancer.org – Mastectomy - https://www.cancer.org/cancer/breast-cancer/treatment/surgery-for-breast-cancer/mastectomy.html
Web MD – Preventative Mastectomy - https://www.webmd.com/breast-cancer/guide/preventive-mastectomy
Cancer.org – Treatment of Ductal Carcinoma - https://www.cancer.org/cancer/breast-cancer/treatment/treatment-of-breast-cancer-by-stage/treatment-of-ductal-carcinoma-in-situ-dcis.html
Cleveland Clinic –Mastectomy (Breast Removal) - https://my.clevelandclinic.org/health/treatments/21221-mastectomy-breast-removal