Mastectomy: types, indications, procedure, recovery and considerations

Types and variants

• Partial mastectomy / lumpectomy: removal of the tumor and a margin of surrounding tissue, often followed by radiation.
• Simple or total mastectomy: removal of all breast tissue without routine removal of axillary lymph nodes.
• Modified radical mastectomy: removal of the breast and some lymph nodes under the arm (axillary dissection).
• Radical mastectomy: a more extensive historical operation that removed chest wall muscles as well as breast and lymph nodes; now rarely used.
• Skin-sparing and nipple-sparing mastectomy: preserve skin and sometimes the nipple-areola complex to permit more natural reconstruction.

Indications and decision factors

Common reasons for mastectomy include a diagnosis of invasive breast cancer or ductal carcinoma in situ when breast-conserving surgery is not suitable, large tumor size relative to breast size, multicentric tumors, or recurrent disease after prior radiation. Some people with a high inherited risk of cancer opt for prophylactic mastectomy to reduce future risk. The decision balances oncologic safety, cosmetic outcomes, personal preferences, and available reconstructive options. Counseling often involves a surgical oncologist, plastic surgeon and other members of a multidisciplinary team.

Procedure and immediate care

Mastectomy is usually done under general anesthesia. The surgeon makes an incision and removes breast tissue according to the chosen technique. At the same time, a sentinel lymph node biopsy or axillary dissection may be performed to assess whether cancer has spread to regional nodes. In many cases breast reconstruction can be performed immediately or delayed to a later date. Reconstruction options include implants or autologous tissue flaps taken from the abdomen, back or other donor sites.

Adjuvant treatment and alternatives

After surgery, additional therapies may be recommended depending on pathology: systemic treatments such as chemotherapy or targeted drugs, and local therapy like radiation therapy. Radiation uses concentrated energy to destroy remaining cancer cells and may be offered after partial resections or when nodes are involved. In some early cancers, breast-conserving surgery plus radiation is an effective alternative to mastectomy.

Risks, recovery and long-term considerations

• Short-term risks: bleeding, infection, wound healing problems and accumulation of fluid (seroma).
• Long-term issues: numbness, chronic pain or phantom sensations, lymphedema after node removal, and changes in body image.
• Reconstruction carries its own risks and may require further operations.

Recovery timelines vary; most people resume many daily activities within weeks but may need longer for full physical and emotional recovery. Rehabilitation may include physical therapy to restore shoulder mobility and lymphatic care to reduce swelling.

History and special populations

Historically, extensive operations were common, but practice shifted toward less radical surgery as understanding of cancer biology improved. Sentinel node techniques and breast-conserving approaches reduced the need for wide dissections. Mastectomy is used across populations: it treats male breast cancer, and chest-contouring mastectomy is a well-established component of gender-affirming care for transgender men and nonbinary people. People considering mastectomy are usually offered multidisciplinary counseling, second opinions and psychosocial support to address medical and emotional aspects of the decision.

For general information about the surgical process see surgery guidance. For further reading on outcomes and reconstructive choices consult resources such as breast health summaries and specialist centers focused on breast cancer.