A mastectomy is an operation to remove the entire breast. It is usually done to treat breast cancer. A double mastectomy involves the removal of both breasts.
The two main types of surgery for breast cancer are:
- breast conserving surgery, which involves removing the part of the breast affected by cancer
- mastectomy, where the whole breast is removed
Mastectomy may be recommended if the breast cancer is large compared with the breast size or there is more than one cancer in the breast.
Some women with a high risk of breast cancer may choose to have a mastectomy to reduce their risk. This is called preventive, or, 'prophylactic' mastectomy.
How to prepare for mastectomy
If you are having a mastectomy, you will probably first meet with a surgeon and an anaesthetist to discuss the surgery. You may be able to have breast reconstruction immediately after the mastectomy. If so, you can discuss this with the plastic surgeon before the surgery.
What happens during a mastectomy?
The procedure is usually performed under general anaesthetic, which means you are asleep during surgery. The surgeon will make a cut around the breast to remove the breast tissue. The skin covering the breast and nipple may also be removed. The operation usually takes 1 to 2 hours. It may take longer if you have a breast reconstruction right after the mastectomy.
What to expect after the procedure
After a mastectomy, you may need to stay in hospital a day or a week, depending on your situation. You may feel some pain, discomfort or numbness in your breast or armpit while your wound heals. There may be fluid build-up around the scar (seroma), which may need to be drained. Speak to your doctor about possible side effects of the surgery. Most side effects can be managed or reduced.
What can go wrong
If you also had some lymph nodes removed from your arm or shoulder, you may experience numbness or tingling in the arm or shoulder. While this can improve over time, the feeling in these areas may change permanently.
Removal of the lymph nodes may also increase the risk of a condition called lymphoedema. The symptoms of lymphoedema are swelling of the breast, arm, hand or chest that lasts after the initial side effects of surgery go away.
Mastectomy and your feelings
Any surgery can be stressful and emotional. Talking to someone close to you, a breast care nurse, or any of the hospital staff may help you to adjust physically and emotionally.
Breast cancer and its treatment, such as mastectomy, can also have a significant impact on body image, feelings of femininity and self-esteem. It’s normal to feel embarrassed or be less interested in sex, for example. But most women adjust to the changes in their body and sexuality over time; this varies a lot between individual women.
You should discuss your feelings towards your body image and sex with your breast care nurse or doctor, and your partner if you have one. Your healthcare provider may refer you to a sexual health counsellor or psychologist if you need more specialised help.
Undergoing a breast reconstruction or wearing a prosthesis or ‘breast form’ after a mastectomy can help improve self-confidence. These are synthetic breasts or parts of a synthetic breast worn inside a bra (or attached to the body with adhesive) to give the appearance of a real breast.
The most important thing is to focus on yourself as a whole person, rather than focus on the part of you that has changed.
Visit the Cancer Australia website for more information about mastectomy and other treatments for breast cancer.
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Last reviewed: April 2020