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Mastectomy
Mastectomy is breast cancer surgery that removes the entire breast. This includes all of the breast tissue and sometimes other nearby tissues.
On this page
- When is mastectomy used for breast cancer?
- Types of mastectomy
- Who might get a mastectomy?
- Does mastectomy improve survival?
- Does mastectomy lower the chance of cancer recurrence?
- Breast reconstruction surgery after mastectomy
- Aesthetic flat closure (“going flat”)
- Recovering from a mastectomy
- Possible side effects
- Treatment after mastectomy
When is mastectomy used for breast cancer?
You might get a mastectomy if you:
- Cannot be treated with breast-conserving surgery (lumpectomy).
- Choose mastectomy over breast-conserving surgery for personal reasons.
- Are at very high risk of getting a second breast cancer.
Some people at very high risk of a second breast cancer choose to have both breasts removed. This is called a double mastectomy or a bilateral mastectomy.
Types of mastectomy
For this surgery, your entire breast is removed along with the skin, nipple, areola, and the covering (fascia) of the pectoralis major muscle, which is the main chest muscle.
A few underarm lymph nodes might ?be removed as part of a sentinel lymph node biopsy. This will depend on the situation. Most people can go home the next day if they are hospitalized.
This combines a simple mastectomy with the removal of the lymph nodes under the arm, called an axillary lymph node dissection.
For a radical mastectomy, the surgeon removes the entire breast, underarm (axillary) lymph nodes, and the pectoral (chest wall) muscles under the breast.
This extensive surgery was once very common, but it is rarely done now.
Less extensive surgery, such as the modified radical mastectomy, has been found just as effective and with fewer side effects. Radical mastectomy might still be done if the tumor is growing into the pectoral muscles.
For this surgery, most of the skin over the breast is left in place. Only the breast tissue, nipple, and areola are removed. The amount of breast tissue removed is the same as with a simple mastectomy.
Implants or tissue from other parts of the body can often be used during the surgery to reconstruct the breast.
Many people prefer a skin-sparing mastectomy because there is less scar tissue and the reconstructed breast seems more natural. But it may not be possible for larger tumors or tumors close to the surface of the skin.
The risk of local cancer recurrence with this type of mastectomy is the same as with other types.
Experts recommend that skin-sparing mastectomies be done by a team of breast surgeons with a lot of experience in this procedure.
A nipple-sparing mastectomy is similar to a skin-sparing mastectomy, but the nipple and areola are left in place while the breast tissue is removed. This is often followed by breast reconstruction. During the surgery, the tissue under the nipple is checked for cancer. If cancer cells are found, the nipple and areola are removed.
This type of surgery may be an option for some people with small, early-stage cancers when there is no sign of cancer in the skin or nipple and the cancer is not close to the nipple (usually more than 2 cm away).
A few important things to consider:
- The nipple may not get enough blood after surgery. This can cause it to shrink or change shape.
- There is a good chance you will have less feeling or no feeling in the nipple because nerves are cut.
- If your breast is larger, the nipple may not be in its usual position after reconstruction.
- There may be a slightly higher chance of leaving behind small amounts of breast tissue.
Surgical techniques have improved, so the risk of cancer coming back in the same area is about the same as with other types of mastectomy in carefully selected people. Many experts consider this a safe option for certain women.
Because this is a more specialized procedure, it is best done by a surgical team with experience in nipple-sparing mastectomy.
When both breasts are removed, it is called a double mastectomy or a bilateral mastectomy.
Double mastectomy is sometimes done as a preventive surgery to reduce the risk of breast cancer for women at very high risk, such as those with a BRCA gene mutation.
Most of these mastectomies are simple mastectomies, but some may be nipple-sparing. A double mastectomy might be part of a breast cancer treatment plan in other situations as well. This is done after careful consideration and discussion between the person and their cancer care team.
Who might get a mastectomy?
Many women with early-stage cancers can choose between breast-conserving surgery and mastectomy. A person might choose a mastectomy for many reasons, and it may be a better option for some people. In some cases, it’s the only option.
Mastectomy may be recommended in certain situations. For example, if:
- You cannot have radiation therapy.
- You prefer to avoid radiation and choose more extensive surgery.
- You already had radiation to the breast.
- Prior breast-conserving surgery did not remove all the cancer, even with repeat surgery.
- Multiple areas of cancer exist in different parts of the breast.
- The tumor is large compared to your breast size.
- You are pregnant and would need radiation during pregnancy.
- You have a gene mutation, such as BRCA, that raises your risk of another cancer.
- You have certain connective tissue diseases, like lupus or scleroderma, that could increase your risk of side effects and complications with radiation.
- You have inflammatory breast cancer.
Does mastectomy improve survival?
In most cases, mastectomy does not give you any better chance of long-term survival compared to breast-conserving surgery.
Studies following thousands of women over many years show that breast-conserving surgery combined with radiation offers the same survival as mastectomy.
Does mastectomy lower the chance of cancer recurrence?
Having a mastectomy, instead of breast-conserving surgery plus radiation, only lowers your risk of developing a second breast cancer in the same breast. It does not lower the chance of the cancer coming back in other parts of your body, including the opposite breast.
Breast reconstruction surgery after mastectomy
After a mastectomy, you might choose to have your breast mound rebuilt to restore its appearance. This is called breast reconstruction.
Every person’s situation is different, but most people can have reconstruction after mastectomy. This surgery might be done at the same time as the mastectomy or at a later time.
Planning ahead: If you are thinking about having reconstructive surgery, it’s a good idea to discuss it with your breast surgeon and a plastic surgeon before your mastectomy. This gives the team time to plan the treatment that’s best for you, even if you wait until later to have the reconstructive surgery.
Insurance coverage: Insurance companies usually cover breast reconstruction, but you should check with your insurance so you know what’s covered.
Learn more about reconstructive surgery in Breast Reconstruction.
Aesthetic flat closure (“going flat”)
Some people choose not to have reconstructive surgery. This is sometimes referred to as "going flat". Wearing a breast form (breast prosthesis) is an option if you want the shape of a breast under your clothes without having surgery.
People who go flat often have a procedure called an aesthetic flat closure or flat closure.
This involves removing extra fat, skin, and other tissue in the breast area during surgery. The leftover tissue is tightened and smoothed out to flatten the chest wall. Learn more in Breast Reconstruction Alternatives.
Recovering from a mastectomy
- After a mastectomy, many people can go home the same day (outpatient surgery).
- Some people may need to stay in the hospital for 1 or 2 nights (inpatient surgery).
How long does it take to recover?
The amount of time you need to recover depends on the type of surgery you have. Many people can get back to most daily activities within about 4 weeks. Recovery may take longer for some people, especially if reconstruction was also done.
How do I care for myself after surgery?
Before you go home, your healthcare team will give you instructions on how to care for yourself. This often includes:
- How to care for the surgery area and dressings.
- How to tell if an infection is starting.
- When and how to bathe or shower.
- How to manage your drain, if you have one. This is a small tube coming out of the surgery area. The tube is attached to a plastic bulb outside your body. The bulb collects any fluid that builds up as you heal.
You will also get information about recovery and daily activities, such as:
- When to use your arm again and how to do exercises to prevent stiffness
- When you can wear a bra or use a breast form
- What medicines to take, including pain medicine and possibly antibiotics
- Any limits on physical activity
Your team will also explain what to expect as you heal, including:
- Possible numbness or changes in feeling in your chest or arm
- Emotional changes and feelings about body image
- When to return for follow-up visits
Possible side effects
As with any surgery, bleeding and infection at the surgery site are possible.
Other possible side effects can depend on the type of mastectomy you have. Complex surgeries tend to have more side effects. These can include:
- Pain or tenderness at the surgery site
- Swelling at the surgery site
- Buildup of blood in the wound (hematoma)
- Buildup of clear fluid in the wound (seroma)
- Limited arm or shoulder movement
- Numbness in the chest or upper arm
Nerve pain (neuropathic pain) that does not go away can happen in the chest wall, armpit, and/or arm. This is sometimes described as burning or shooting pain. It is also called post-mastectomy pain syndrome or PMPS.
Lymphedema and other side effects can happen if axillary lymph nodes were also removed. Lymphedema is swelling in the arm or chest.
Treatment after mastectomy
To help lower the risk of the cancer coming back, some women might get endocrine therapy (hormone therapy) or other treatments after a mastectomy.
Some women might also need chemotherapy (chemo) or targeted therapy after surgery. If so, radiation therapy and hormone therapy are usually delayed until chemo is finished. Ask your cancer care team what to expect.
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- References
Developed by the 黑料大湿Posts Cancer Society medical and editorial content team with medical review and contribution by the 黑料大湿Posts Society of Clinical Oncology (ASCO).
Henry NL, Shah PD, Haider I, Freer PE, Jagsi R, Sabel MS. Chapter 88: Cancer of the Breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 7th ed. Philadelphia, PA: Elsevier; 2024.
Jagsi R, King TA, Lehman C, Morrow M, Harris JR, Burstein HJ. Chapter 79: Malignant Tumors of the Breast. In: DeVita VT Jr, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023
National Cancer Institute. Aesthetic flat closure. Accessed at https://www.cancer.gov/publications/dictionaries/cancer-terms/def/aesthetic-flat-closure on March 10, 2026.
National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: Breast Cancer. Version 2.2026. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/breast.pdf March 9, 2026.
Last Revised: July 1, 2026
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