Mastectomy — breast cancer treatment or prevention

A mastectomy is surgery to remove your breast. A bilateral (double) mastectomy involves the removal of both breasts.

Mastectomy for breast cancer treatment

A mastectomy is usually done to treat breast cancer. Breast cancer is when cells start to grow abnormally in your breast. It can spread to other parts of the body.

A mastectomy can be done as a treatment for breast cancer or preventatively for people with a high risk of developing breast cancer. Mastectomy as treatment is performed when you have a confirmed diagnosis of breast cancer. 

Mastectomy for breast cancer prevention

Preventative, or ‘prophylactic’ mastectomy, may be chosen by people with a high genetic risk of breast cancer. This surgery is often a bilateral mastectomy, which involves the removal of both breasts. 

A mastectomy may be recommended for several reasons, including if:

• the breast cancer is large compared with your breast size
• there is more than one cancer in your breast
• you have had breast cancer before

Some people with breast cancer choose to have a mastectomy rather than breast-conserving surgery (surgery where the tumour is taken out without removing the whole breast).

It is important that you feel that you are involved in deciding on your treatment plan for breast cancer. Discuss with your doctor what your main goals are and ask questions to make sure you understand what options are available in your situation.

The procedure is usually performed under general anaesthetic, which means you are asleep during surgery.

Your surgeon will make a cut around your breast to remove the breast tissue. The skin covering your breast and nipple may also be removed. One or more lymph nodes are also usually removed from under your arm.

You may also choose to have breast reconstruction at the same time as your mastectomy. This is a surgery to replace breast tissue with an implant or tissue from other parts of your body. 

Breast reconstruction can also happen in a separate, delayed surgery if you prefer. You can discuss the benefits and risks of these options with your healthcare team. 

If you are having a mastectomy, you will meet with your surgeon and anaesthetist to discuss the surgery.

You may be able to have breast reconstruction surgery immediately after the mastectomy. If so, you can discuss this with the plastic surgeon before the surgery.

Your doctor will also talk with you about whether you need to stop taking any of your usual medicines before your surgery. They will ask you to fast (stop eating and drinking) several hours before having the surgery.

After a mastectomy, you may need to stay in hospital for up to a week, depending on your situation.

You may feel some pain, discomfort or numbness in your breast or armpit while your wound heals. You can take pain-relief medicines to help — your doctor will advise you on this.

You will have a dressing over your wound. You may also have a drainage tube to drain fluid from the wound. Your doctor and breast care nurse will show you how to care for your wound.

Ask your breast care nurse about your recovery and what to expect after your mastectomy.

Speak to your doctor about possible side effects of the surgery. Most side effects can be treated or managed.

Your doctor will discuss the risks of surgery with you, including the risks of any procedure, such as:

• risks with the anaesthetic
• bleeding
• infection

Your doctor will also talk with you about risks or possible complications of mastectomy, which can include the following:

• fluid build-up around your scar
• shoulder and arm stiffness
• pain, numbness and tingling
• lymphoedema

Infection

Infection is a possible complication after any surgery, including mastectomy. Signs of infection can include:

• swelling
• redness
• pain
• heat
• discharge (fluid from the wound)

Your healthcare team will discuss with you how to best manage your wound to prevent infection and how to treat infection if it occurs. 

Breast cancer and its treatment, such as mastectomy, can impact your body image and self-esteem. Some people experience a reduced libido (desire for sex) after having a mastectomy. It's also common to feel a sense of loss or grief.

You can discuss feelings about body image and sex with your breast care nurse or doctor, and your partner if you have one. A sexual health counsellor or psychologist may be able to help if you need more help.

Having a breast reconstruction, wearing a prosthesis or using a 'soft form' (a temporary prosthesis) after a mastectomy may help improve your self-confidence. Breast prostheses are synthetic (artificial) breasts or parts of a synthetic breast that you can wear inside a bra, or attach to your body with special glue. You can usually start to wear a prosthesis 1 to 2 months after your mastectomy.

Mastectomy is one type of surgery for breast cancer. The other type is breast-conserving surgery. This is where just the part of your breast affected by cancer is removed.

If you decide not to have a mastectomy, your doctor may have other treatment options for breast cancer. Depending on the cancer, this may include:

• breast-conserving surgery
• radiation therapy
• chemotherapy
• hormone therapy

It is important to discuss your options with your healthcare team. They can answer your questions, explain the benefits and risks, and help you make an informed decision that is right for you.

The thought of surgery can be stressful and may trigger many emotions. Talking to someone may help you to adjust physically and emotionally. You can talk to someone close to you, your breast care nurse, your doctor or a counsellor.

Visit the Cancer Council (Opens in new tab) for more information about mastectomy (Opens in new tab) and breast cancer (Opens in new tab) or call the Cancer Council on 13 11 20.

The Breast Cancer Network Australia (Opens in new tab) has a webpage on how to best prepare for a hospital stay for breast cancer surgery (Opens in new tab). You can contact their hotline on 1800 500 258.

Languages other than English

Breast Cancer Network Australia has resources on breast cancer (Opens in new tab) in many community languages. 

Cancer Council has fact sheets on different types of cancer in several languages.

Information for Aboriginal and/or Torres Strait Islander peoples

My Breast Cancer Journey (Opens in new tab) is a guide for Aboriginal and/or Torres Strait Islander peoples.

Cancer Australia has an information booklet on breast cancer (Opens in new tab) available for Aboriginal and/or Torres Strait Islander peoples.

Breast Cancer Network Australia has a resource page (Opens in new tab) for Aboriginal and/or Torres Strait Islander peoples. 

Our Mob and Cancer has a page about breast cancer (Opens in new tab).

Information for sexually and gender-diverse people

Breast Cancer Network Australia has information on body image and gender (Opens in new tab) in the context of breast cancer.

Cancer Council has information available for gender diverse people on dealing with cancer (Opens in new tab).