Surgery to remove the whole breast is called a mastectomy. You may be offered a mastectomy if:
- there is cancer in more than one area of the breast
- the cancer is large compared to the size of the breast
- you have had radiation therapy to the same breast before and so cannot have it again
- clear margins cannot be obtained
- you find out that you have the BRCA1 or BRCA2 gene mutation at the time of your breast cancer.
You may decide that you would prefer a mastectomy rather than breast-conserving surgery, especially if you can’t have radiation therapy. Some women choose a mastectomy even for a very small cancer.
Most mastectomies remove the nipple with the breast. In some cases, the surgeon may be able to perform a skin-sparing or nipple-sparing mastectomy. This means that more of the normal skin – with or without the nipple – is kept. It allows the surgeon to do an immediate breast reconstruction.
If you don’t have an immediate reconstruction, you can wear a soft temporary breast prosthesis inside your bra while your surgical wound heals. After this time, you can be fitted for a permanent breast prosthesis.
Some women who need a mastectomy because of cancer in one breast choose to have the other breast removed as well. This surgery is known as a contralateral prophylactic mastectomy. Your surgeon may recommend a double mastectomy if you have the BRCA1 or BRCA2 gene mutation, because the mutation increases the risk of developing another breast cancer. Some women with average risk also choose to have a double mastectomy, even though it does not normally make any difference to survival rates.