A radical mastectomy is a type of surgical procedure in which a breast is removed, typically as a treatment for breast cancer. There are multiple different types of mastectomy procedures, providing women with breast cancer with several options for surgical intervention. In a simple mastectomy, the affected breast is removed, but lymph nodes and other tissues are not touched. In a radical mastectomy, the entire breast is removed, along with muscles beneath the breast, the nearest lymph nodes, and some of the tissue surrounding the breast.
Varying amounts and types of tissue are removed in each type of procedure depending on the extent to which the breast cancer has invaded surrounding tissues. When a simple mastectomy is performed, the cancer generally has not spread from the breast. In these cases the lymph nodes remain intact; however, the nodes are generally biopsied to ensure they are free from cancer. A simple mastectomy is the preferred option in most cases of breast cancer, particularly when it is not possible to remove only a portion of the breast.
A radical mastectomy is carried out when cancer is known to have spread. Here, the intention is to remove tissues surrounding the breast to ensure that all of the cancerous tissue is excised during the procedure. This is a fairly invasive procedure, due to removal of part of the pectoralis major muscle in addition to the breast and lymph nodes. In some cases a portion of shoulder muscle must also be removed.
When possible, a modified radical mastectomy is performed in preference to a radical mastectomy. This type of surgery is preferred because it is significantly less disfiguring than a radical procedure. In the modified version of the operation, the breast and lymph nodes are removed, but the pectoralis major chest muscle and shoulder muscle remains intact. This is typically the best option for a woman who must have a radical procedure, as leaving the muscles intact means she may opt for breast reconstruction surgery at a later date.
The procedure is carried out under general anesthetic, and takes three or more hours to complete, due to the complexity of the operation. Women who undergo this surgery will have a hospital stay of up to two days, and an average healing period of around four weeks. In all cases, the mastectomy is generally followed with an additional treatment such as chemotherapy. This is necessary because there is always a risk that some cancer cells may still remain in the body. Even one remaining cancer cell can potentially cause a tumor to regrow; therefore chemotherapy is an important part of treatment.