A simple mastectomy is a surgical procedure done on a patient to remove all of the breast tissue. This procedure is normally done on patients who have been diagnosed with breast cancer that has not spread to the surrounding lymph nodes. It can also be done as preventive therapy for those patients who are at an increased risk of developing breast cancer.
The extent and type of breast cancer surgery is usually based on the size or type of the tumor. A simple mastectomy, also referred to as a total mastectomy, is done on patients who have larger tumors or have more than one tumor in the breast. These patients may not qualify for a less invasive surgery, known as a lumpectomy, which is done to remove a cancerous lump while leaving the remaining breast tissue intact. Patients who are experiencing a recurrence of breast cancer following an initial lumpectomy may also need to undergo a simple mastectomy.
Patients with a strong family history of breast cancer may choose to have genetic testing done to look for mutations in the BRCA-1 and BRCA-2 breast cancer genes. After careful discussion with a physician, patients with mutations in the breast cancer genes may choose to have a simple mastectomy. This is done as a preventive measure before any cancer develops.
Prior to surgery for breast cancer, the diagnosis must be confirmed. The patient must undergo a variety of tests including an X-ray of the breast tissue, called a mammogram. Chest X-rays may be taken to look for cancer that may have spread beyond the breast tissue. Computed tomography (CT) scans will also give the surgeon a clear picture of the location of the tumor.
The patient may also have a needle biopsy done, in which tissue is removed from the breast using a hollow needle. This tissue is then sent to a medical laboratory for examination by a pathologist. The pathologist will examine the sample for cancer cells.
A simple mastectomy is performed under general anesthetic and should take about two hours. An oblong incision is first made around the breast tissue with a scalpel. The skin containing the nipple along with all the breast tissue is removed. Pectoralis muscles that lie under the breast tissue are not removed during the simple mastectomy. The surgeon may choose to remove the closest lymph node to check for cancer cells, but the remaining lymph nodes are left in place.
During the surgery, the surgeon will insert a plastic drainage tube in the area around the breast to drain any fluid that may accumulate following surgery. This drainage tube may need to remain in place for a week. A normal hospital stay for a patient undergoing a simple mastectomy is two days. This stay could be longer if the patient chooses to have breast reconstruction surgery done at the same time.
Recovery from the simple mastectomy could take up to six weeks. The patient should avoid heavy lifting or strenuous activity during the recovery period. Physical therapy may be necessary if there is any loss of movement in the arm or shoulder.
