Mastectomy
1. Simple (also known as total mastectomy)
A simple mastectomy includes removal of the breast tissue, skin and nipple but rarely lymph nodes. This procedure is sometimes done for prophylactic reasons when a strong probability of developing breast cancer exists. A woman may opt for breast reconstruction or choose to wear a breast prosthesis following this procedure. The chest wall is usually left fairly flat following a simple mastectomy and the woman has many choices in breast prosthetics.
2. Modified radical mastectomy
A modified radical mastectomy is the most common form of mastectomy performed. This procedure includes removal of the entire breast, nipple and areola and varying amounts of lymph nodes in the underarm region. There is usually one horizontal incision about 5-8 inches long and if no reconstruction is done, the healed chest wall is typically flat or slightly rippled. This procedure can also be performed through a much smaller incision near the areola to create a skin sparing mastectomy. This technique works well if immediate reconstruction is planned. Today a modified radical mastectomy is done when breast conserving surgery is not the woman's best option.
3. Radical Mastectomy
A radical mastectomy includes the removal of the breast tissue, skin, nipple, areola, underlying chest muscles and varying numbers of lymph nodes in the underarm region. Prior to 1970 this was a common surgery used for breast cancer. This procedure is now reserved for diagnoses of advanced disease as studies have shown survival rates are equal with that of the less invasive modified radical mastectomy. This surgery usually creates more difficulty with range of motion in the arm and shoulder on the operative side. Physical therapy is sometimes required to restore shoulder mobility. The chest wall usually has concave areas that can be problematic when finding a well fitting breast prosthesis.
4. Partial Mastectomy (also known as breast conserving surgery)
A partial mastectomy or breast conserving surgery involves removing a portion of the breast along with the tumor and varying numbers of lymph nodes. This procedure can also be referred to as lumpectomy, segmentectomy, or quadrantectomy depending on how much tissue is removed. Generally, large tumor to breast size ratio leaves the patient with poor cosmetic results.