With mastectomy, surgeons remove the entire breast, usually including the nipple. We don’t remove the muscle on the chest wall (the pectoral muscle), although if the cancer is very close to it, we may take out a small piece of muscle underneath the tumor. Depending on the stage of the breast cancer, we may advise you to undergo radiation therapy after mastectomy as well.
If you have a mastectomy, you’ll have to decide whether you want the breast to be reconstructed and which type of reconstruction would work best for you. Breast reconstruction can be performed safely either during the mastectomy or as a second, separate procedure done at any time — even years later.
Other Types of Mastectomies
- Skin-sparing mastectomy: With this technique, we remove the inner breast tissue and nipple and leave a shell of skin in place. We then either fill the area with tissue from your abdomen or place a tissue expander underneath the pectoral muscle, insert an implant and, later, reconstruct the nipple. This approach results in a more natural-looking breast. For almost all women, the reconstructed nipple doesn’t have any sensation, and it’s likely that you’ll have significant numbness in the remaining skin.
- Nipple-sparing mastectomy: For certain women with small cancers that are not located near the nipple, we can preserve the nipple and areola. Sensation is changed and the nipple won’t become erect or function like it normally did. But many women find this approach gives them excellent cosmetic results.
- Preventive mastectomy: A preventive, or prophylactic, mastectomy involves surgically removing the breasts as a precautionary measure. The procedure lowers the risk that a woman will develop breast and ovarian cancers. Women with an inherited risk of breast cancer due to mutations in the BRCA1 or BRCA2 genes may choose to have this operation.
Our researchers have measured the risk-reduction benefits associated with these procedures, all of which we offer at Memorial Sloan Kettering. Our renowned reconstructive breast surgeons can help women who have prophylactic surgery at MSK.