Mastectomy - What to Expect

A mastectomy is an operation to remove breast tissue - and is most commonly performed as part of treatment for breast cancer. In some cases - it may also be recommended to significantly reduce the risk of breast cancer for people at very high risk. A mastectomy may be advised if the cancer involves a large area of the breast, or if there are multiple areas of cancer present. It may also be recommended if radiotherapy is not suitable; has already been given; or if you have a high genetic risk such as a BRCA gene mutation. There are several types of mastectomy. A total mastectomy, sometimes called a simple mastectomy, involves removal of all breast tissue. A skin-sparing mastectomy removes the breast tissue while preserving most of the skin. A nipple-sparing mastectomy preserves both the nipple and areola - though this is not suitable for everyone. A risk-reducing mastectomy, also known as prophylactic mastectomy, may be performed to lower future cancer risk in those with significant genetic predisposition. Mastectomy may be performed on one breast, which is called unilateral, or on both breasts, which is called bilateral. Your surgeon will explain which type of mastectomy is most appropriate for your situation. This decision will be made together, taking into account your diagnosis, overall health, and personal wishes. Many people choose to have breast reconstruction following mastectomy. This can be performed at the same time as the mastectomy, known as immediate reconstruction, or at a later date, known as delayed reconstruction. Reconstruction may use implants or your own tissue - and your surgeon will discuss the options with you. Reconstruction is entirely optional, and choosing not to have reconstruction is equally valid. Before surgery, you will meet your surgical and anaesthetic teams, have any necessary pre-operative assessments and scans, and receive guidance about fasting, medications, and what to expect during recovery. You will have time to ask questions and consider your options carefully. Your clinical team is there to support you through every step of this process. Recovery varies from person to person. A hospital stay of one to three days is typical. You may have temporary surgical drains in place, and it is common to experience some discomfort or tightness in the chest area. Most people return to normal activities gradually over several weeks. Your team will provide advice on wound care, arm exercises, pain relief, and follow-up appointments. As with any surgery, mastectomy carries some risks. Possible side effects include pain or numbness around the chest or arm, infection, bleeding, and scar formation. Other possible effects include seroma, which is a collection of fluid, and changes in sensation. Your surgeon will explain these risks in detail and discuss how they are minimised for your individual situation. A mastectomy can have a significant emotional impact, affecting body image, confidence, and overall wellbeing. Support is available throughout your journey - including breast care nurses, counselling or psychological support services, and peer support groups where you can connect with others who have had similar experiences. A mastectomy is a significant step - but you will not face it alone. Your clinical team will guide you through every stage, from preparation to recovery. To discuss your individual circumstances or next steps, please contact my team to arrange a consultation.