In many cases of breast cancer, complete mastectomy may be required to give a woman the best chance for a cure. Some women may prefer mastectomy instead of breast conservation. Mastectomy refers to the removal of the entire breast and skin around the nipple. Modified radical mastectomy refers to removing the lymph nodes under the arm along with the breast. This is performed for invasive breast cancer. Simple (or Total) mastectomy is sometimes performed for noninvasive cancer and leaves the lymph nodes in place.
Prophylactic simple mastectomy is sometimes performed in women who are at high risk for developing breast cancer. High risk may be defined as family history of pre menopausal breast cancer in mother or sister, history of breast cancer on the other breast, history of pre cancer of the breast, or presence of the breast cancer gene (BRCA 1 or BRCA 2). This is a very aggressive option in the fight against breast cancer and fortunately, prophylactic (cancer prevention) mastectomy is very rarely needed. The decision for prophylactic mastectomy is difficult, requiring much thought and the opinion of several doctors.
Many options for reconstruction exist after mastectomy. Reconstruction can be performed at the time of the cancer surgery or it can be delayed. Saline implants or one’s own tissue can be used to create a new breast. Your surgeon can discuss these many options with you.