What is a mastectomy?

In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely.

Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. It is also the medical procedure carried out to remove breast cancer (tissue) in males.

Lumpectomy

Alternatively, certain patients can choose to have a wide local excision (also called a lumpectomy), an operation in which a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are what are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

Mastectomy Operation

Traditionally, in the case of breast cancer, the whole breast was removed. Often the mastectomy was performed during the same operation in which the biopsy was taken that confirmed the diagnosis. Nowadays the decision to do the mastectomy is usually based on the earlier performed biopsy. Also there is a trend to a more conservative approach to breast cancer. Practice has changed, on the one hand, due to improvements in radiotherapy and adjuvant treatment (e.g. chemotherapy or hormonal therapy) which mean a wider excision no longer makes local recurrence less likely, and on the other hand a recognition that breast cancer metastasizes early. Radical excision will not prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis and operation.

Mastectomy rates vary tremendously world-wide, as was documented by the 2004 'Intergroup Exemestane Study', an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries. The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.