The term mastectomy, unless qualified, refers to total removal of the breast. The incision for this operation usually includes the nipple, as the ducts from the breast (which may contain cancer cells) extend all the way up to the surface.

A modified radical mastectomy includes removal of the axillary lymph nodes, and a radical mastectomy (exceedingly rarely performed) also involves removing the pectoralis major (“pec”) muscle.

The surgical site must be monitored indefinitely to make sure the cancer has not returned (recurred). This can occur even when the entire breast is removed, because islands of cells can break free and lodge in adjacent sites. Also, the breast tissue interdigitates with the layer of fatty tissue under the skin, and tiny islands of breast tissue are left behind when the breast is removed. Women who have cancer scattered in multiple areas of the breast (multicentric) are better treated by a mastectomy.

Most women who have a mastectomy will not need radiation. Certain circumstances, such as spread of the cancer to four or more lymph nodes in the armpit area, will require radiation.

Reconstruction of the breast is an option, either immediately or at a later time. Many factors, both personal and medical, must be taken into consideration prior to making a decision regarding one’s operation.