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Why it's done
By Mayo Clinic staffMastectomy is used to remove all breast tissue if you have breast cancer or are at especially high risk of developing it. You may have a mastectomy to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy).
Mastectomy for breast cancer treatment
Mastectomy may be a treatment option for many types of breast cancer, including:
- Ductal carcinoma in situ (DCIS), or noninvasive breast cancer
- Stages 1 and 2 (early-stage) breast cancer
- Stage 3 (locally advanced) breast cancer — most often after chemotherapy to shrink the tumor
- Inflammatory breast cancer — most often after chemotherapy
- Paget's disease of the breast
- Locally recurrent breast cancer
Your doctor may recommend mastectomy instead of lumpectomy plus radiation if:
- You have two or more tumors in separate areas of the breast.
- You have widespread or malignant-appearing calcium deposits (microcalcifications) throughout the breast that have been determined to be cancer after a breast biopsy.
- You've previously had radiation treatment to the breast region and the breast cancer has recurred in the breast.
- You're pregnant and radiation creates an unacceptable risk to your unborn child.
- You've had lumpectomy, but cancer is still present at the edges (margin) of the operated area and there is concern about cancer elsewhere in the breast.
- You carry a gene mutation that gives you a high risk of developing a second cancer in your breast.
- You have a large tumor relative to the overall size of your breast. You may not have enough healthy tissue left after lumpectomy to achieve an acceptable cosmetic result.
- You have a connective tissue disease, such as scleroderma or lupus, and may not tolerate the side effects of radiation to the skin.
- You live a long distance from a radiation facility and it would be very difficult to be there for treatment over an extended period of time.
Mastectomy to prevent breast cancer
You might also consider mastectomy if you don't have breast cancer, but have a very high risk of developing the disease. Preventive (prophylactic) or risk-reducing mastectomy involves removing both of your breasts and significantly reduces your risk of developing breast cancer in the future. Prophylactic mastectomy is reserved for women with a very high risk of breast cancer, which is determined by a strong family history of breast cancer or the presence of certain genetic mutations that increase the risk of breast cancer.
- Breast cancer treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/breast/healthprofessional/AllPages. Accessed Aug. 18, 2011.
- Breast cancer risk reduction. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Aug. 18, 2011.
- Modified radical and total mastectomy. In: Khatri VP, et al. Operative Surgery Manual. Philadelphia, Pa.: Saunders Elsevier; 2003. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B0-7216-7864-5..X5001-9&isbn=0-7216-7864-5&uniqId=273959611-3. Accessed Aug. 18, 2011.
- Iglehart JD, et al. Diseases of the breast. In: Townsend CM Jr., et al. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1565/0.html. Accessed Aug. 18, 2011.
- Surgery for breast cancer. American Cancer Society. http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-treating-surgery. Accessed Aug. 18, 2011.
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