What is breast cancer?

Breast cancer is a harmful growth that starts in the glandular tissue of your breast.

What is a mastectomy?

A mastectomy involves removing all of your breast, usually including your nipple. As well as removing your breast tissue, your surgeon may remove lymph nodes in your armpit to find out if there are any cancer cells in them.

What are the benefits?

Removing the cancer by surgery gives the best chance of you being free of early breast cancer. The breast tissue and lymph nodes that your surgeon removes will be examined under a microscope to help decide on any further treatment.

If you have advanced breast cancer it is unlikely that surgery will lead to you being cured. Surgery, together with other treatments, may control the cancer and improve your quality of life.

Are there any alternatives to a mastectomy?

If you have invasive breast cancer (which means the cancer cells may spread), there are other treatment available such as hormone therapy, chemotherapy, radiotherapy and biological therapy.

For most men, combining surgery with one or more of the other treatments will further improve the chance of being free of early breast cancer.

What will happen if I decide not to have the operation?

The cancer may not be controlled by other treatments, or the cancer may be controlled at first and then spread in a few months or years.

Not removing the cancer by surgery will reduce the chance of you being cured.

What does the operation involve?

The operation is performed under a general anaesthetic and takes 1 to 2 hours.

Your surgeon will make a cut on your breast to include the nipple and remove your breast tissue.

Your surgeon will remove any lymph nodes from your armpit usually through the same cut.

Your chest on the side of the operation will be flat. Your wound should heal to a faint line across the side of your chest.

All your breast tissue and lymph nodes that have been removed will be examined under a microscope. Your surgeon will know the results 1 to 2 weeks later.

What complications can happen?

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, you are a smoker or have other health problems. These health problems include diabetes, heart disease or lung disease.

Some complications can be serious and can even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Blood clot in your leg (deep-vein thrombosis – DVT).
• Blood clot in your lung (pulmonary embolus), if a blood clot moves through your bloodstream to your lungs.
• Chest infection — your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Developing a lump under your wound caused by fluid collecting.
• Developing a lump under your wound caused by blood collecting (a haematoma).
• Numbness or continued pain around your armpit or the inner part of your arm. Any pain usually gets better within a few weeks. Numbness can last for up to 6 months and can sometimes be permanent.
• Skin necrosis, where some of the skin at the edge of your wound dies leaving a black area.
• Stiff shoulder.
• Arm weakness or swelling of your arm and hand. You can get lymphoedema months or even years later.
• Asymmetry (different-shaped chest on either side).
• Dissatisfaction with the appearance of your chest over time.

Less than 1 in 10 patients will get a complication in the first 30 days.

Consequences of this procedure

• pain
• unsightly scarring of your skin

How soon will I recover?

You should be able to go home the same day or the following day.

You should be able to return to normal activities after 2 to 3 weeks.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The healthcare team will arrange for you to come back to the clinic within 3 weeks. The breast tissue and lymph nodes that your surgeon removed will have been examined under a microscope. Your healthcare team will tell you the results and discuss with you any treatment or follow-up you need. They will also be able to tell you when you can return to work.

Breast cancer may come back despite the best available treatment.

Summary

Surgery gives the best chance of you being free of early breast cancer. A mastectomy involves removing all your breast tissue. It usually involves removing some or most of the lymph nodes in your armpit, which helps your healthcare team to decide on any further treatment.

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