Mastectomy

Mastectomy is a surgical procedure which is intended to remove the cancerous tissue by removing the entire breast.  This simultaneously provides treatment for the tumor by removing it, but also helps prevent future recurrence in the same breast by removing the surrounding tissue. 

The word "mastectomy" actually refers to removing breast tissue, but there have traditionally been several types of mastectomy, which differ in the amount of surrounding tissue removed:

• Subcutaneous mastectomy refers to removal of the breast tissue with preservation of the nipple and areola.  This is usually used for treatment of non-cancerous conditions

• Simple (or total) mastectomy is the most commonly performed mastectomy today.  This is intended to remove as close to 100% of the breast tissue as possible, and includes removal of the nipple and areolar area, which contains breast ducts and approximately 5% of all breast tissue.

• Modified radical mastectomy refers to removal of the breast tissue (=simple mastectomy) with removal of the lymph nodes under the armpit.  This usually reserved today for individuals with cancer that has spread to the lymph nodes.

• Radical mastectomy and extended radical mastectomy involve removal of the entire breast, lymph nodes, muscles and in some case ribs adjacent to the cancer.  These are never performed today outside of very specialized centers and are of historical interest only.

The choice of mastectomy or lumpectomy depends on many factors, such as the extent of the cancer, breast size, imaging findings, and patient preference.  The choice is surgery is extremely important, but impacts more on local treatment in the breast than on long term survival (which depends much more on the presence of cancer in the lymph nodes.  See Sentinel Lymph Node Biopsy)