Q: What is a mastectomy?
Marla Ahlgrimm: A mastectomy is essentially a surgical procedure where a physician removes either one or both of a woman’s breasts. It’s often performed when a woman has invasive breast cancer that does not respond to chemo or radiation therapy. A mastectomy may be necessary if the risk of recurrent breast cancer is high.
Q: Why would a woman have both breasts removed?
Marla Ahlgrimm: Even if a woman only has cancer cells present in one breast, she may choose to have both removed to ensure uniformity. Further, women with certain gene mutations that have experienced breast cancer on one side may choose to have both removed to eliminate the possibility of breast cancer returning. A woman may also choose to have the procedure to find peace of mind, even if she is not at high risk for relapse.
Q: What is a total mastectomy?
Marla Ahlgrimm: A total mastectomy involves the removal of all components of the breast. This includes some pectoral muscles along with the nipple and areola.
Q: How is this different from a modified radical mastectomy?
Marla Ahlgrimm: A radical mastectomy is a total mastectomy that also removes lymph nodes under the arm. It is a less invasive version of the formerly common full radical mastectomy.
Q: Do surgeons still perform radical mastectomies?
Marla Ahlgrimm: Rarely, but there are times when it makes sense. A radical mastectomy removes the entire breast along with a significant portion of muscles in the chest wall. Typically, a radical mastectomy is now only performed if tumors are beginning to affect underlying pectoral muscles. Doctors will help a woman decide if this is the right course for her based on known information. A woman will never be suggested a radical mastectomy without being fully informed of the pros and cons.
Q: Is it possible to remove just the breast tissue and not the skin above?
Marla Ahlgrimm: Yes. This is called a skin-sparing mastectomy. A surgeon will essentially empty out the entire breast, leaving the outer tissue intact. This makes it possible for an implant or fat/tissue from other parts of the body to be implanted here. Women who choose a skin-sparing mastectomy are highly encouraged to use a team of surgeons that have ample experience in this type of procedure.
Q: Who is the ideal candidate for a mastectomy?
Marla Ahlgrimm: Many instances of breast cancer can be resolved with radiation therapy or chemotherapy however. Women who do not respond well to this, have the BRCA mutation, or are pregnant when diagnosed with breast cancer are great candidates. Further, women who have large tumors, lupus, scleroderma, or other connective tissue disorders, inflammatory breast cancer, or who have been treated with radiation therapy previously may be recommended a mastectomy.
Q: How long does it take to recover from the procedure?
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Marla Ahlgrimm: Recovery is both physical and mental. The physical recovery begins with a one to two-night stay in the hospital. Women can typically return to their normal activities in about a month. However, the emotional side effects of losing one or both breasts may require counseling and can last for a lifetime.
Marla Ahlgrimm encourages all women over the age of 40 to engage in frequent self-breast exams. Breast cancer continues to kill women every year. Until there is a cure, early detection and treatment is the best course of action.
