Surgery to remove the whole breast is called a mastectomy.
You may be recommended to have 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
- it’s difficult to get a clear margin around the tumour
- you find out that you have the BRCA1 or BRCA2 gene mutation at the time of your breast cancer diagnosis.
You may decide that you would prefer a mastectomy rather than breast-conserving surgery. You can choose a mastectomy even for a very small cancer. After a mastectomy, it’s not common to have radiation therapy but it may be offered in some situations.
Usually the nipple is removed 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. If you have decided to have a reconstruction, the skin- or nipple-sparing mastectomy is usually done at the same time.
If you don’t have an immediate reconstruction, you can wear a soft breast form and a specially designed bra while your surgical wound heals. Breast Cancer Network Australia provides a free bra and temporary soft form. To order a kit, speak to your breast care nurse. After the wound has healed and the area is comfortable, you can be fitted for a permanent breast prosthesis.
What about the other breast?
If you need a mastectomy because of cancer in one breast, you may think it’s safer to have the other breast removed as well.
For most people, the risk of getting cancer in the other breast is low. If you have the BRCA1 or BRCA2 gene mutation, the mutation increases the risk of developing another breast cancer and your surgeon may recommend a double mastectomy.
Whether to have a double mastectomy is a complex decision and it’s best to talk with your treatment team about the risks and benefits.
Prof Bruce Mann, Professor of Surgery, The University of Melbourne, and Director, Breast Tumour Stream, Victorian Comprehensive Cancer Centre, VIC; Dr Marie Burke, Radiation Oncologist, and Medical Director GenesisCare Oncology, QLD; Dr Susan Fraser, Breast Physician, Cairns Hospital and Marlin Coast Surgery Cairns, QLD; Ruth Groom, Consumer; Julie McGirr, 13 11 20 Consultant, Cancer Council Victoria; A/Prof Catriona McNeil, Medical Oncologist, Chris O’Brien Lifehouse, NSW; Dr Roya Merie, Staff Specialist, Radiation Oncology, Liverpool Cancer Therapy Centre, Liverpool Hospital, NSW; Dr Eva Nagy, Oncoplastic Breast Surgeon, Sydney Oncoplastic Surgery, NSW; Gay Refeld, Clinical Nurse Consultant – Breast Care, St John of God Subiaco Hospital, WA; Genny Springham, Consumer.
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