Making the Decision to Have a Mastectomy

If you don’t meet the requirements for breast-conserving surgery, you may want to think about a mastectomy. There are 3 main types of mastectomies.

• Total mastectomy. The surgeon removes your whole breast and often the lining over your chest muscle. It’s also called a simple mastectomy.

• Modified radical mastectomy. The surgeon removes your whole breast, most of the lymph nodes under your arm, and often the lining over your chest muscles. Sometimes your doctor has to remove one of your 2 chest muscles.

• Radical mastectomy. This is rarely done now because of the side effects. This is also called a Halsted radical mastectomy. The surgeon removes both of your chest muscles as well as those tissues removed in a modified radical mastectomy.

The type of surgery you have depends on the stage of your cancer and the size and location of your tumor.

Your doctor may suggest that you have a mastectomy if you fit one or more of the following cases.

• You have Stage 0 DCIS, I, II, or III breast cancer.

• You have Stage IV or metastatic ductal carcinoma and need surgery to ease symptoms.

• You’re pregnant, and the radiation involved with a lumpectomy could harm your unborn baby.

• You have already had radiation treatment on the affected breast.

• You have more than one tumor, and they’re too far apart to do a lumpectomy.

• You’ve had a lumpectomy that didn’t get the whole tumor.

• You have a hardening of your connective tissue, called scleroderma, which would make radiation impossible.

• Your tumor is large compared with your breast size.

• You have lobular carcinoma in situ (LCIS), and you have a high risk of developing breast cancer. Some women choose bilateral prophylactic mastectomy to prevent cancer from developing in either breast.