Mastectomy

A mastectomy involves removal of the whole breast. A simple mastectomy removes only the breast tissue, while a radical mastectomy also removes the muscles on the chest wall. A radical mastectomy is almost never performed these days. The surgeon also usually removes lymph glands from under the arm to check whether any cancer cells have spread from the breast. This helps doctors decide whether other treatment is needed.

Sentinel lymph node biopsy is a way of checking just one or two of the lymph glands to see if they contain cancer. It involves injecting a tiny amount of radioactive liquid into the area of the cancer before the operation. The lymph nodes are then scanned to see which has taken up the radioactive liquid first. A blue dye is also injected into the area of the cancer during the operation. The dye stains the lymph nodes blue. The nodes that become blue or radioactive first are known as the sentinel nodes. The surgeon removes only the sentinel nodes so that they can be tested to see whether they contain cancer cells.  Sentinel node biopsy reduces the chances of side effects such as arm stiffness and swelling (lymphoedema) of the arm that can occur after sampling or clearance of the lymph nodes. It can also cause less pain and does not need a drain into the wound afterwards.

More information can be found at Macmillan Cancer Support.

Here women describe their experiences of having a mastectomy. Most stayed in hospital for a week to ten days.

For some women a mastectomy is the best option, depending on the size of the tumour and the type of cancer. Some women explained why they were given a mastectomy and how they felt about it at the time.

Describes the shock she felt about having a mastectomy.

Explains why she accepted that a mastectomy was the best option for her.

Tess preferred to have a mastectomy rather than a lumpectomy. She felt relieved after surgery and said it felt as if something had been lifted from her and taken away.

One woman had Paget's disease (a rare form of cancer that affects the nipple) for which a mastectomy was the best option. Two women had inflammatory breast cancer, which is also less common, and had mastectomies.

A few women had their mastectomies over 15 years ago, when lumpectomies were less common, and were pleased with their operations and recovery.

Explains that she had a mastectomy 18 years ago, and this was her only treatment.

Some women discussed their experiences of double or bilateral mastectomies.

Explains why she opted for a second mastectomy.

Tess had a family history of breast cancer. Two years after her first mastectomy, she had a second one and breast reconstruction. She was happy with the surgery she had.

Some women described their feelings before having the operation, and one explained how she prepared herself physically for the surgery. Other women discussed aspects of the procedures involved e.g. having drains removed and post-operative exercises. Several women recommended taking painkillers whenever necessary, though one woman declined painkillers because she did not need them.

Describes how she felt before the operation.

Describes how she prepared herself physically for the surgery.

Describes the procedure after the operation.

Explains that after the operation she felt able to start to exercise the following day.

For many women the operation was straightforward. However, a few women experienced complications during or after surgery.

Describes a complication she had after her operation.

Several women felt hungry after the operation or tired shortly afterwards. Many talked about how they felt about their changed body image (see 'Body image'). Some women felt a sense of loss as a result of their experience, and advised allowing time to recover physically and psychologically.

Comments on the sense of loss that many women feel after having a mastectomy.

Meeting other patients helped some women enjoy the hospital experience as well as share their concerns. The visitors, cards and flowers they had received were also considered supportive. Some women said that the hospital care that they had been given helped them to feel looked after and protected. Other women, however, were bored in hospital and eager to go home.

Explains why she enjoyed her hospital experience.

At home, most women said they were careful not to lift anything heavy or over-exert themselves physically, including with housework. Some said they had a bit of pain or discomfort around their wound and under their arm to begin with, and took painkillers to ease it. Many said they had support from family until they felt able to do everything themselves again. Most women recovered well and were able to get on with life as normal. Some women, though, said they had problems with their arm, such as lymphoedema (see ‘Lymphoedema’). Some younger women who had children to look after often found it tiring, especially at first.

It can be difficult having treatment and looking after a new baby. At first Tess was also breastfeeding with her healthy breast.