What should you know about non skin sparing mastectomy?

In a non-skin-sparing mastectomy, the surgeon removes breast tissue together with the nipple, areola and the skin over the breast. The amount of tissue removed and whether lymph nodes are sampled depend on the diagnosis. This approach may be considered when the breast skin or nipple area is affected, when reconstruction will not use the original skin envelope, or when a different surgical shape is safer.

It is different from a skin-sparing mastectomy, which preserves much of the breast skin for reconstruction. The choice is made with the breast and reconstructive teams after reviewing examination findings, imaging and pathology. Breast cancer and Paget disease of the breast are among diagnoses that may require discussion of this operation.

Ask whether reconstruction will happen during the mastectomy or later, and whether a drain will be placed. Before surgery, discuss medicines, smoking, wound care, arm movement and what help you may need at home. The removed tissue is examined to guide further treatment.

Recovery includes caring for the incision, gradually increasing movement and attending follow-up. Some people notice numbness, tightness, altered body image or discomfort around the chest and arm. If lymph nodes are treated, the team can explain lymphoedema risk and available therapy. A lumpectomy may be an alternative for some diagnoses, but it is not suitable for everyone.

Contact the surgical team urgently for fever, spreading redness, pus, sudden swelling, wound separation, uncontrolled pain, or a drain that stops working or fills rapidly. Seek emergency help for chest pain, severe breathlessness or sudden one-sided arm swelling.

Why is a non-skin-sparing operation recommended for me? Will lymph nodes be removed or sampled? Could lumpectomy be appropriate? Will reconstruction be immediate or delayed? What will the scar and chest contour be like? Which arm exercises, wound signs and swelling symptoms should I watch for?