Mastectomies are differentiated by how the procedure is performed and how much tissue is removed. They include:
Simple Mastectomy
A simple mastectomy is also known as a total mastectomy. During this procedure, the surgeon removes the entire breast, including:
- All the breast tissue
- The nipple and areola
- The covering of the chest muscle
- The skin
The surgeon may also remove one to three lymph nodes from under the armpit. The removed lymph nodes will be tested to determine if the cancer has spread to the lymphatic system.
Modified Radical Mastectomy
This procedure is a more-extensive form of mastectomy. It involves removing the entire breast, including:
- All the breast tissue
- The nipple and areola
- The covering of the chest muscle
- The skin
- Between 10 and 40 lymph nodes from the armpit area
By removing a larger number of nodes than a simple mastectomy, the surgeon can assess the cancer’s potential spread more accurately.
Radical Mastectomy
This extensive procedure is not often performed in modern-day breast cancer treatment. It involves removing the entire breast, including:
- All the breast tissue
- The nipple and areola
- The covering of the chest muscle
- The chest (pectoral) muscle
- All underarm lymph nodes
- The skin
This procedure was once common. Studies have shown, however, that less-extensive surgeries are just as effective in most cases while causing fewer side effects. Accordingly, doctors prioritize the less-extensive surgeries in most situations. A full radical mastectomy generally is recommended only if the tumor has grown into the pectoral muscles.
Skin-Sparing Mastectomy
If the breast cancer tumor is small, a skin-sparing mastectomy may be possible. This type of mastectomy is performed to preserve the breast skin, allowing for immediate breast reconstruction. It removes:
- All the breast tissue
- The nipple and areola
- The covering of the chest muscle
Breast reconstruction follows immediately after the mastectomy. This creates less scar tissue and a reconstructed breast that appears more natural. As a result, most patients prefer a skin-sparing mastectomy. However, this procedure is possible only for patients with smaller tumors. If the tumor is large or close to the skin, a simple or modified radical mastectomy is typically recommended.
Nipple-Sparing Mastectomy
If there is no cancer present in the nipple and areola, a nipple-sparing mastectomy may be possible. This type of mastectomy preserves most of the skin, the nipple, and the areola, allowing for immediate breast reconstruction. The surgeon removes:
- All the breast tissue and milk ducts
- The covering of the chest muscle
Breast reconstruction usually follows immediately after the mastectomy. This is the preferred option for patients with very small, early-stage tumors because it results in the fewest scars. If there is any sign of cancer in the nipple and areola, however, they must be removed. If any cancer cells are missed and not removed, the cancer may recur or spread.
Partial Mastectomy
Also called a lumpectomy, this procedure removes the least amount of breast tissue. The surgeon removes only the part of the breast that contains cancer, in addition to a small circular area around it, to prevent recurring tumors. The rest of the breast tissue is preserved. This procedure is possible in early-stage cancers when the tumor is small and has not spread. When possible, it is often the preferred approach by doctors and patients alike.
Double Mastectomy
A double mastectomy is a mastectomy performed on both breasts simultaneously. It can involve any other type of mastectomy. While it may be performed to remove tumors in both breasts, it is most often a preventative measure. Removing the other breast will drastically reduce the risk of breast cancer recurring after treatment.