Many cancers can be treated with breast conserving surgery.
There are some situations however, where a complete mastectomy is
the most suitable form of treatment.
A modified radical mastectomy is the standard operation in these
situations. All of the breast tissue, overlying skin and the nipple
are removed to leave a thin transverse scaracross the chest. The
chest-wall muscles are preserved.
Reasons for mastectomy include:
- Large tumour
- Multiple tumours
- Patient unwilling or unable to have radiotherapy after
- Cancer recurrence following breast-conserving surgery
- Patient preference
Patients who have a mastectomy do not usually require
radiotherapy to the chest wall unless the margin of excision is
inadequate or there are multiple axillary nodes affected by the
After mastectomy you will be provided with a soft temporary
prosthesis to wear inside your bra. Once the wound is healed you
will be fitted with a permanent external prosthesis that is
measured to match your other breast in size and weight. Some women
with a large breast size elect to have a reduction procedure on the
healthy breast. This reduces the asymmetry and helps with dressing
What to expect after surgery:
Both partial and full mastectomy operations are performed under
a general anaesthetic and require about two to two and a half hours
in theatre. A plastic suction drain will be inserted to drain any
fluid that may build-up in the first few days after surgery. The
drain is usually removed after 2-3 days, before you leave hospital.
The incisions are closed with dissolving sutures positioned under
the skin and this means that no stitches need to be removed. You
will spend 2-3 nights in hospital and by the time you are
discharged you should be quite mobile and able to manage all
routine activities. Pain is usually easily controlled with Panadol
or other simple pain tablets. There will be a waterproof, plastic
dressing covering the wound and you can bath and shower as
Possible complications after mastectomy
Bruising - is common and will settle in a
couple of weeks.
Bleeding - occasionally there may be extensive
bleeding into the tissues that can cause painful swelling. This is
called a haematoma and you may need to go back to theatre so that
the bleeding can be controlled properly.
Wound infection - causes the wound to
become tender, warm and swollen. There may be redness and discharge
of pus from the wound. You may feel feverish. Antibiotics will be
Seroma - A collection of fluid may form at
the site of surgery. This can be easily drained in the clinic with
a needle and syringe. Fluid build-up usually stops within 3- 4
Decreased sensation - There may be areas of
numbness in the skin of the breast and also along the inside of
Balance and posture - After mastectomy some
women may notice a change in posture due to loss of the breast.
Wearing a breast prosthesis will help.
Local recurrence - even after a full mastectomy
there is a 5-10% chance that the cancer could recur either on the
chest wall or in the scar.
Emotional and psychological effects - the
diagnosis and treatment of breast cancer can have significant
effects on a womens' self-esteem, body image and relationships.
Please discuss any concerns or difficulties in this area. Support
and professional counselling are available.
Breast Prosthesis Subsidy There is a government subsidy
available for purchasing a suitable prosthesis.
Read more about terms and conditions of HFA subsidy at
Breast Prosthesis Subsidy
A request form can be completed after your surgery.
There are a number of specialist shops that provide advice
and assistance with selecting a prosthesis
Anita Breast Care Centre 1st Floor
Lingerie World, Silverdale Ph 09 4275283
or 0800 264822
Naturalwear Surgical fitting service 120 Symonds street,
Royal Oak, Auckland Ph 09 6243718
Amoena prosthetic range