What should you know about radical mastectomy?

Radical mastectomy removes the whole breast, the chest muscles underneath it and lymph nodes in the armpit. It is an extensive operation and is different from more limited forms of mastectomy. The exact procedure depends on where the disease is and whether nearby tissues are involved.

A breast surgeon may discuss this operation when cancer has extended into chest-wall muscle or when a less extensive procedure would not remove all affected tissue. The removed tissue is examined to guide further treatment. Recovery can include wound discomfort, restricted shoulder movement, numbness, swelling or lymphoedema. Reconstruction may be immediate or delayed, and some people choose an external breast form instead.

Treatment plans can include surgery alone or other treatment before or after surgery. A mastectomy is different from a lumpectomy, which removes the tumour and a margin while preserving much of the breast.

Before surgery, ask which tissues will be removed, whether drains are expected, and how arm movement will be supported. Arrange help with washing, dressing and household tasks during the early recovery period. Follow wound and drain instructions, take prescribed pain relief as directed, and begin shoulder exercises only when the surgical team says they are suitable. Keep scheduled appointments so pathology results and the next treatment steps can be reviewed.

Contact the surgical team promptly for increasing redness, warmth, swelling, wound separation, cloudy drainage, worsening pain or a fever. Seek urgent help for sudden breathlessness, chest pain, fainting, heavy bleeding or rapidly worsening swelling. New arm heaviness or tightness should also be reported, because early assessment can support lymphoedema care.

Which structures do you expect to remove, and why is this extent of surgery recommended? Will I need a drain or physiotherapy? When will pathology be available? What reconstruction or prosthesis choices fit my treatment plan? Which symptoms should lead me to call the hospital?