MASTECTOMY SURGERY

Breast cancer is one of the biggest fears a woman will have as it almost certainly needs some sort of operation, the very least to be removing a tumour. For many years the mastectomy operation included removal of the muscles behind the breast leaving only a thin skin covering the ribs. Radiotherapy would follow leaving more skin damage and scarring.

Mastectomy surgery now involves removing the breast together with the skin covering the breast and the nipple but rarely having to remove the breast muscle as well. This procedure is known as a simple mastectomy and as this type of surgery leaves a covering of skin on the chest, there is less disfigurement. The scar is usually no more than a fine line across the chest and this fades in time.

 
There are two alternative types of mastectomy surgery available, for very early cancer, called skin sparing mastectomy or where no cancer exists, called subcutaneous mastectomy but the breasts are removed as a precaution if the woman is at an extremely high risk of getting the disease.

Skin sparing mastectomy: One or two cuts are made into the skin of the breast, mostly around the nipple, to remove the nipple,  the areola, the darker circle of skin around the nipple and the breast tissue under these incisions. The rest of the breast skin is left in place.

Subcutaneous mastectomy: The infra-mammary fold, the skin fold under the skin is cut and the breast tissue is removed through this cut, but the nipple, areola and the rest of the breast skin is left behind.

There are two approaches to restoring your breasts after surgery, breast reconstruction and breast prostheses. Every attempt is made to bring the breasts back to their original shape and to look as normal as possible.

 
  Breast prostheses:

Breast prostheses are false breasts that are offered to women who have had lumpectomy surgery or where a large incision has been made which has altered the breast shape noticeably

A lightweight foam prostheses which fits inside the bra is used for the first month after surgery while the tissues are still tender. It is called a cumfie or softie.

The permanent prostheses, usually made from silicone, will be fitted when the surgery is fully healed. They are close to the weight of a real breast and often come complete with the nipple.

Breast prostheses are free from the NHS or Breast Cancer Care.

If you are looking for mastectomy surgery information, the following links may also be of interest to you:

 

Breast reconstruction:

Your surgeon should have already discussed breast reconstruction before the mastectomy surgery as it is sometimes done at the same time as the mastectomy operation. This is called an immediate reconstruction. If it is going to be done later it is called a delayed reconstruction.

Breast reconstruction is normally done by a specialist plastic surgeon and not by the breast surgeon but they sometimes work side by side. It will mean different appointments sometimes in different hospitals but it is important to discuss everything that is on offer.

If you are having radiotherapy the breast reconstruction will be delayed as the radiation can sometimes affect the appearance of the reconstructed breast.
 
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