This surgical procedure involves removal of the entire breast, surrounding tissue and nipple areolar complex. Today this is done in conjunction with a sentinel lymph node biopsy. This is the procedure that all others have been compared to in dealing with local control of disease within the breast.
Indications for mastectomy today include multicentric cancers, multifocal tumors, large tumors, cases where breast conservation will not allow for a satisfactory cosmetic outcome, instances where patients have had prior radiation therapy to the breast, locally advanced breast cancers, inflammatory breast cancer, women with BRCA1 or BRCA2 gene mutations and those women who desire mastectomy for personal reasons. Furthermore, it is an operation that is offered to women who have recurrent breast cancer.
Breast reconstruction can be done at the same time but it’s important to note that women who will need radiation after mastectomy therapy should consider having their reconstruction done after all of their therapies have been completed.
There are many different types of mastectomies, not limited to:
- Simple Mastectomy – removal of the breast tissue, skin and nipple areola complex
- Skin Sparing Mastectomy – removal of all the breast tissue and nipple areola complex, leaving a skin envelope for breast reconstruction
- Nipple Sparing Mastectomy – removal of all the breast tissue with preservation of the skin of the nipple areola complex
A sentinel lymph node biopsy is usually added to any of the above procedure when breast cancer has been diagnosed.
When a mastectomy is combined with an axillary lymph node dissection is called a Modified Radical Mastectomy (MRM).