Most of us understand the term mastectomy as the procedure of removing breast tissue either as part of cancer treatment or to prevent cancer. But there are actually several types of mastectomy that fall under this umbrella.
The most drastic of these procedures is the radical mastectomy. It was once prevalent, but today, oncologists only recommend it in certain circumstances.
What is a radical mastectomy, and how does it differ from other types of breast removal? We explain in detail below.
What is a Radical Mastectomy?
A radical mastectomy is a breast cancer treatment. Unlike other types of mastectomies, it’s not a preventative procedure.
When you have a radical mastectomy, your remove not only the breast tissue but also your chest muscles and underarm lymph nodes.
As a result, oncologists only include it as a course of treatment when breast cancer spreads from the breast tissue into your chest muscles.
However, in the past, health care providers used it as a more traditional type of mastectomy.
There is also a second type of radical mastectomy: the modified radical mastectomy. In this procedure, the surgeon removes your breast and the majority of your auxiliary lymph nodes. However, they spare your chest muscles.
How Do Radical Mastectomies Differ from Simple Mastectomies?
As treatments and understanding of breast cancer have evolved, doctors now focus on trying to be more conservative regarding the breast tissue they remove.
A simple mastectomy differs from both types of radical procedures because it focuses on removing the breast tissue (including the areola, nipple, and skin). Still, it leaves some of the lymph nodes behind, particularly the ones underneath your arm.
These procedures are available to you if your breast cancer remains contained within your breast tissue.
What is the Most Conservative Breast Cancer Treatment?
In terms of tissue removed, the list of breast cancer treatments falls in the following order (from most tissue lost to least):
- Radical mastectomy
- Modified radical mastectomy
- Simple mastectomy
A lumpectomy is the most conservative of the treatments because you don’t lose your breast.
Instead, a surgeon removes the tumor and a portion of the surrounding tissue. It’s also known as breast-conserving surgery (or wide local excision).
Lumpectomies are more often used in very early-stage breast cancer when the doctor confirms that the cancer cells are very localized. You may have a lumpectomy followed by radiation therapy.
However, lumpectomies are also used as a diagnostic tool (excisional biopsy). Your care provider may use the procedure to confirm or rule out a breast cancer diagnosis.
In some cases, you may qualify for a lumpectomy treatment, but the procedure could damage the look and size of your breast. In these cases, your doctor may recommend a full mastectomy, and you can choose to have breast reconstruction.
Recovery from a lumpectomy is shorter than from a mastectomy, which requires one or two nights in the hospital after your treatment.
How Soon Can You Get Breast Reconstruction After a Mastectomy?
There are three answers to this question because the timeline depends on:
- the stage of your cancer
- the facilities available in your area
- your general health
- your personal decision
If you have a mastectomy, but you still need to complete radiation and chemotherapy, then your doctor will advise you to wait until you finish your treatments. In this case, waiting six to 12 months after your surgery is called delayed reconstruction.
In the event that you don’t need further chemotherapy or radiation, then your surgeon can schedule your mastectomy and breast reconstruction at the same time. The surgery is known as immediate reconstruction, and while you’re asleep, two surgical teams work together to remove your breast and reconstruct it. These are most common when you are having a prophylactic mastectomy (to reduce your risk of breast cancer) rather than when your mastectomy is part of your treatment plan.
Not all women fit neatly into the timelines above, and for those women, there’s a newer approach to reconstruction called delayed-immediate reconstruction.
A delayed-immediate reconstruction is a staged approach to the surgery. Here, you might receive some restoration immediately after your mastectomy. Then, when your doctors decide what course of radiation and chemotherapy are needed, they begin to schedule the final reconstruction, usually starting two weeks after your last radiation treatment.
What Can You Wear After a Mastectomy?
If you need or choose to wait for reconstruction surgery, then you might wonder what to wear after your mastectomy.
Your body looks and feels different after a mastectomy, and women’s clothing tends to be designed for women who have two breasts.
Today’s mastectomy clothing options are now much more like the clothes you shopped for before your surgery than surgical care items. You can even get mastectomy-friendly lingerie similar to what you enjoyed wearing in the past.
Unfortunately, you probably won’t find most of it at your local department store – at least not yet. But specialty shops and online retailers off them.
If you don’t like shopping online, Nordstrom is an excellent place to shop for both mastectomy bras and modified bras. Nordstrom’s Certified Prosthesis Fitters happily add prosthetic pockets to their bra ranges for you. They also take insurance and can help you fill out Medicare paperwork.
Are You About to Have a Mastectomy?
There are several different types of mastectomies, and a radical mastectomy is the most complex of them. It involves removing not only your breast but also your chest muscle. Your oncologist will only recommend the procedure if your cancer spread to your chest muscle or if a tumor is pressing against your muscle wall.
Every woman has her own experience with having a mastectomy. While you didn’t choose a mastectomy, you can choose what happens next. The process of breast reconstruction is almost entirely up to you.
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