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Falls Canyon Surgical Associates

Mastectomy – Breast Cancer Surgery: What You Need to Know

*Disclaimer
The information provided on this webpage and its external links, is intended for general informational and independent research purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the direct guidance of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Do not disregard or delay seeking professional medical advice based on information obtained from this site.

What is a Mastectomy?

A mastectomy is a surgical procedure to remove one or both breasts, typically performed to treat or prevent breast cancer. There are several types of mastectomy depending on the diagnosis and treatment plan.

Why Is It Done?

A mastectomy may be recommended for a variety of clinical and personal reasons, depending on the diagnosis, cancer extent, and individual risk factors.

  • Breast cancer treatment: Used when removal of the entire breast is needed to effectively treat invasive breast cancer and achieve the best oncologic outcome.
  • DCIS (ductal carcinoma in situ): May be recommended when DCIS is extensive, widespread, or not well-suited for breast-conserving surgery.
  • High genetic risk (e.g., BRCA mutation): Sometimes performed as a preventive (prophylactic) surgery to significantly reduce the risk of developing breast cancer in high-risk patients.
  • Recurrence after prior treatment: Considered if cancer returns following previous treatments such as lumpectomy and radiation.
  • Personal choice: Some patients elect mastectomy instead of lumpectomy and radiation for personal preference, peace of mind, or to avoid ongoing surveillance and radiation therapy

Types of Mastectomy

  • Total (Simple) Mastectomy: Removes the entire breast, including the nipple and areola.
  • Skin-Sparing Mastectomy: Preserves most of the breast skin for reconstruction.
  • Nipple-Sparing Mastectomy: Preserves the breast skin and nipple-areola complex.
  • Modified Radical Mastectomy: Removes the entire breast along with lymph nodes under the arm.
  • Double Mastectomy: Both breasts are removed, often as a preventive measure in high-risk patients.

Your surgeon will recommend the best option based on your cancer stage, location, breast size, and personal preferences.

Preparing for Surgery

  • Initial Consultation: Where you meet with the surgeon who will be performing the surgery and discuss treatment options.
    • Talk to your surgeon about reconstruction options—some procedures can be done at the same time as mastectomy.
  • Pre-Op Tests: Some patients may require blood tests and an EKG before surgery. Please complete all blood tests and EKGs within 30 days of surgery, and no later than two weeks before, to allow time for any needed repeats.
  • Imaging: CT/CAT scans, ultrasounds, or an MRI may be performed to determine the best and most safe surgical approach.
  • Medications: Inform your doctor about all medications and supplements, especially blood thinners.
  • Smoking: Stop smoking before surgery to promote better healing. Some insurances may require this step in order to authorize surgery. Check with your healthcare provider if you have questions about this.
  • Prep the Night Before:
    • Use the provided antibacterial soap to wash the area the night before and morning of the surgery. This excludes hemorrhoid procedures.
    • Clean clothes and clean sheets gets you prepared for surgery.
  • Fasting: Do not eat or drink anything for at least 6–8 hours before surgery.
  • Transportation: It is required that you arrange for someone to drive you home after the procedure.

It is very important that you properly prepare yourself for surgery as it allows for your doctor to perform the surgery safely and effectively. If you’re preparing for a colectomy, please visit the link below to view more detailed instructions on how to prepare for surgery.

Visit our Preparing for Surgery Page

What to Expect During Surgery

  • Performed under general anesthesia
  • Surgery usually lasts 1–3 hours, depending on whether reconstruction or lymph node removal is included
  • A drain may be placed near the incision to remove fluid
  • Most patients stay in the hospital 1–2 nights, though some go home the same day

After the Procedure:

  • Hospital stay:
    • May be a day or two for an uncomplicated mastectomy however some patients go home the same day.
    • Longer hospital stay may be required if there were other complications during surgery.
  • At home recovery:
    • Most patients resume light activity within a few days
    • Most patients return to work or school around 2-4 weeks after surgery
    • Depending on working conditions, lifting restrictions may be in place until fully healed at around 4-6 weeks.
    • Full recovery typically takes 4-6 weeks

In some cases a drain may be placed to help the surgical site heal. These drains will most likely be removed within 10 days of the surgery at a post-op appointment with your doctor.

What to Expect:

  • Expect soreness, swelling, and limited arm movement for a few days
  • Pain is usually well controlled with prescribed medications
  • Your surgeon will advise you when to return to daily activities (usually 4–6 weeks)
  • Avoid heavy lifting and vigorous activity until cleared by your care team
  • Emotional support and counseling may be helpful during recovery

Contact your doctor if you experience:

  • Fever over 100.4°F (38°C)
  • Redness or drainage at the incision site
  • Persistent nausea or vomiting
  • Increasing pain or swelling
  • Yellowing of the white part of the eye (Jaundice).

Risks and Complications

While generally safe, possible risks include:

  • Bleeding or infection
  • Poor wound healing
  • Fluid buildup (seroma)
  • Numbness or stiffness in the chest or arm
  • Shoulder mobility issues
  • Lymphedema (swelling of the arm, if lymph nodes are removed)

Your surgical team will take precautions to minimize risks and will discuss these with you beforehand.

Frequently Asked Questions (FAQs)

Will I need radiation or chemotherapy after a mastectomy?
Possibly. Your care team will make recommendations based on your tumor type, lymph node involvement, and other factors.

Can breast cancer return after a mastectomy?
Yes, recurrence is possible, although the risk is lower. Regular follow-up and imaging help monitor for recurrence.

Is breast reconstruction required?
No. Reconstruction is optional. You can choose immediate reconstruction, delayed reconstruction, or no reconstruction at all. All options are valid and personal.

Is breast reconstruction covered by insurance?
Yes. Under U.S. law, insurance providers must cover breast reconstruction following mastectomy, including procedures on the opposite breast for symmetry.

When can I return to work or exercise?
Most people return to light work within 2–4 weeks. Full recovery may take 6–8 weeks or longer depending on the extent of surgery and reconstruction.

Will I need to wear a special bra or prosthesis?
Yes. Your care team may recommend a post-surgical bra, and some patients use a breast prosthesis if not undergoing reconstruction.

Will I have drains after surgery?
Yes, temporary surgical drains are often placed to remove fluid and are usually removed within 1–2 weeks.

How long does the surgery take?
A mastectomy typically takes 2–3 hours, but this may be longer if reconstruction is performed at the same time.

Will I have numbness in my chest?
Yes, numbness around the chest and incision area is common and may be long-lasting or permanent.

Can I sleep on my side after surgery?
You may need to sleep on your back initially; side sleeping is usually allowed once healing progresses and your surgeon clears you.

Will lymph nodes be removed?
In some cases, lymph nodes are removed to check for cancer spread, which may affect recovery and risk of swelling (lymphedema).

What is lymphedema?
It is swelling, usually in the arm, that can occur if lymph nodes are removed or treated. Your care team will review prevention strategies.

When can I shower after surgery?
Most patients can shower within a few days, but specific instructions will be provided based on your surgical plan.

Will I need physical therapy?
Some patients benefit from arm exercises or physical therapy to restore range of motion after surgery.

Support and Resources

  • Oncology social workers, therapists, and support groups can provide emotional and practical support.
  • Physical therapy may be helpful to improve shoulder mobility and reduce swelling.
  • Ask your team about local and online support options.

Need Support or Have Questions?

Your care team is here to help. If you’ve been diagnosed with a breast mass or are recovering from a mastectomy, don’t hesitate to contact us with questions about your treatment or recovery.