Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Why it's done

By Mayo Clinic staff

The goal of mastectomy is to remove all breast tissue if you have breast cancer or are at especially high risk of developing it. You may have a mastectomy in one or both breasts.

Physically removing the tumor is the single most effective treatment for breast cancer. Removal and examination of breast tissue and nearby lymph nodes also provides important information to help guide future treatment decisions.

Mastectomy may be a treatment option for many types of breast cancer, including:

  • Ductal carcinoma in situ (DCIS)
  • Stages 1 and 2 (early-stage) breast cancer
  • Stage 3 (locally advanced) breast cancer
  • Inflammatory breast cancer (after therapy to reduce skin swelling and inflammation)
  • Paget's disease of the breast
  • Locally recurrent breast cancer
  • Phyllodes tumor

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.
  • You've previously had radiation treatment to the breast region.
  • You're pregnant, when radiation creates an unacceptable risk to your unborn child.
  • You've had lumpectomy, but cancer is still present.
  • You carry a gene mutation that gives you a high risk of developing a second cancer in your breast.

You might also choose mastectomy over lumpectomy if:

  • 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 have a skin condition called xerodoma pigmentosa.
  • 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.

You might also consider mastectomy if you don't have breast cancer, but are at high risk of developing the disease. Preventive (prophylactic) or risk-reducing mastectomy removes one or both of your breasts in hopes of preventing or reducing your risk of developing breast cancer in the future.

If your cancer is very large or aggressive or you have inflammatory breast cancer, your doctor may recommend that you have chemotherapy before surgery (neoadjuvant therapy) to shrink the tumor.

Risks Definition
References
  1. Kass RB, et al. Breast procedures. In: Souba W, et al. ACS Surgery: Principles and Practice. 6th ed. Philadelphia, Pa.: BC Decker Inc.; 2007.
  2. Benson JR, et al. Early breast cancer. The Lancet. 2009;373:1463.
  3. Breast cancer. Merck Manuals Online Medical Library for Health Care Professionals. http://www.merck.com/mmpe/print/sec18/ch253/ch253e.html. Accessed Sept. 10, 2009.
  4. Sabel MS, et al. Mastectomy and breast conserving therapy for invasive breast cancer. http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2009.
  5. Breast cancer. NCCN Practice Guidelines in Oncology - v. 1.2009. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed Sept. 10, 2009.
  6. Iglehart JD, et al. Surgical treatment of breast cancer. In: Townsend CM, et al. Sabiston Textbook of Surgery, 18th ed. Philadelphia, Pa.: Saunders, 2007. http://www.mdconsult.com/das/book/body/154656547-3/875806831/1565/335.html#4-u1.0-B978-1-4160-3675-3.50038-1--cesec62_1699. Accessed Sept. 10, 2009.
  7. Hayes DF. An overview of breast cancer and treatment for early stage disease. http://www.uptodate.com/home/index.html. Accessed Sept. 10, 2009.
  8. Surgery for breast cancer. American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_5.asp?sitearea=. Accessed Sept. 10, 2009.
  9. Mastectomy. MedlinePlus Medical Encyclopedia. http://www.nlm.nih.gov/medlineplus/ency/article/002919.htm. Accessed Sept. 10, 2009.
  10. Giuliano AE. Breast. In: Doherty GM, et al. Current Surgical Diagnosis & Treatment. McGraw-Hill's AccessMedicine. http://www.accessmedicine.com/popup.aspx?aID=2064014&pr. Accessed Sept. 10, 2009.
  11. What's new in breast cancer research and treatment? American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_6X_ _Whats_new_in_breast_cancer_research_and_treatment_5.asp?rnav=cri. Accessed Sept. 10, 2009.
  12. Abeloff MD, et al. Cancer of the breast. In: Abeloff MD, et al. Abeloff's Clinical Oncology, 4th Ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008.  http://www.mdconsult.com/das/book/body/159336554-2/0/1565/335.html?tocnode=54737888&fromURL=335.html#4-u1.0-B978-1-4160-3675-3..50038-1--cesec57_1694. Accessed Sept. 10, 2009.
  13. Breast cancer treatment (PDQ). National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional. Accessed Sept. 10, 2009.
  14. Phan GQ, et al. Breast diseases. In: Klingensmith ME, et al. The Washington Manual of Surgery. Philadelphia, Pa: Lippincott Williams & Wilkins;2008. http://ovidsp.tx.ovid.com/spb/ovidweb.cgi QS2=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. Accessed Sept. 10, 2009.

MY00943

Oct. 17, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger