Understanding mastectomy

A woman diagnosed with breast cancer hopes she can recover without the need for a mastectomy. But when it is a woman’s best course of action, it’s important she understand several things about the procedure. We asked Dr. Daniel Howard, a surgeon with Grogan and Howard medical practice group in Paducah, about the different types of mastectomies, and what a woman should expect.

What is a mastectomy?

A mastectomy is a surgery to remove a breast. There are five types: partial mastectomy, “simple” or total mastectomy, modified radical mastectomy, radical mastectomy, and subcutaneous (nipple-sparing) mastectomy.

What’s the difference in the various types?

A partial mastectomy, also known as a lumpectomy, removes just the cancerous tumor part of the breast tissue and a little normal tissue around it. This is usually followed by radiation therapy.

A “simple” or total mastectomy removes the entire breast and skin. It may be associated with removal of one or more lymph nodes under the arm.

Modified radical mastectomies involve removing multiple lymph nodes and breast tissue. This makes reconstruction much more challenging, but still possible. During a full radical mastectomy, a surgeon also will remove the chest wall muscles under the breast.

When reconstruction is planned, usually a subcutaneous, or skin-sparing mastectomy, is done. This removes the breast tissue, but the nipple is left alone. This is most common in women who want reconstruction. We frequently perform a skin and nipple-sparing mastectomy in younger women.

How long does a mastectomy usually take?

A single-side mastectomy usually takes one to one-and-a-half hours. Both sides take between two to two-and-a-half hours. A partial mastectomy is generally a little faster.

How long is a mastectomy patient usually in the hospital?

A partial mastectomy is done usually as outpatient surgery. Any of the other mastectomies usually require one to two days in the hospital.

What’s the recovery process?

Generally, after a mastectomy, people can return to work in about a month. But there is a huge variable, depending on age and job type.