Mastectomy – Breast Cancer Surgery: What You Need to Know

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ℹ️What 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

📝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

🩺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.

🛌After the Procedure:

🏥 In the Hospital:
- Some patients go home the same day but some patients must stay in the hospital 1–2 days, depending on the type of surgery and their recovery.
- You will receive IV fluids, pain medication, and antibiotics as needed.
- Your healthcare team will monitor your pain, incision site, and overall recovery.
- Surgical drains are commonly placed to remove fluid from the surgical area and help with healing.
- You will receive instructions on drain care, incision care, activity restrictions, and follow-up appointments before discharge.
- If lymph nodes are removed, you may receive additional instructions regarding arm movement and monitoring for swelling.
🏡 At Home:
- Recovery typically takes 4–6 weeks, depending on the type of mastectomy and whether additional procedures were performed.
- Continue light walking and gentle movement to improve circulation and prevent stiffness.
- Avoid heavy lifting, strenuous activity, and excessive arm movement until cleared by your surgeon.
- Care for surgical drains as instructed and record daily drainage amounts if requested.
- Wear supportive garments as recommended to improve comfort and protect the surgical area.
- Attend all follow-up appointments to monitor healing, remove drains, review pathology results, and discuss additional treatment options.

🩹 What to Expect:

Mild to moderate soreness, tightness, or pressure across the chest
Swelling and bruising around the surgical area
Temporary numbness or changes in sensation of the chest or underarm
Fatigue during the first several weeks
Limited arm movement or stiffness, especially if lymph nodes were removed
Surgical drains until fluid buildup decreases
A scar along the chest where breast tissue was removed
Emotional changes related to body image and recovery

📞 Contact your surgeon if you experience:

Fever over 100.4°F (38°C) or chills
Redness, warmth, swelling, or drainage from the incision
Increasing pain or sudden swelling of the chest or surgical area
Significant changes in drain output or concerns with drain function
Persistent nausea and/or vomiting
New arm swelling, tightness, or decreased range of motion
Chest pain or shortness of breath

It is always recommended to keep a written account with a timeline of any symptoms you may be experiencing and when you take medications.

⚠️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.