When is mastectomy recommended for breast cancer?

Mastectomy removes breast tissue; the exact operation may include removal or preservation of the nipple and skin, depending on the tumour and reconstruction plan. Lymph nodes may also be assessed or treated. The decision considers tumour size and position, breast shape, genetic or family-risk information, previous radiotherapy and the possibility of obtaining clear margins. Breast-conserving surgery followed by radiotherapy may be an alternative for some people, but it is not appropriate in every situation.

Ask the breast surgeon to compare mastectomy with breast-conserving surgery for your specific scans and biopsy results. Discuss reconstruction, prostheses, nipple or skin preservation, lymph-node surgery, scars, sensation and recovery. A plastic surgeon, oncology nurse or counsellor can help with practical and emotional preparation. Bring someone you trust if that helps you remember information, and request time to consider the options.

Before treatment, report a rapidly enlarging breast change, severe pain, fever, spreading redness, wound drainage or sudden breathlessness to your care team. After surgery, urgent review is needed for heavy bleeding, severe shortness of breath, fainting, uncontrolled pain or a rapidly swollen wound. A new breast change does not by itself show that cancer has returned, but it warrants assessment.

Why are you recommending mastectomy in my case? Is breast-conserving surgery suitable? What lymph-node procedure is planned? What reconstruction choices and timing are available? How might previous treatment or genetic findings affect the recommendation?