The Who, What, Where, When and Sometimes, Why.

What is a Mastectomy?

A mastectomy is the surgical removal of the entire breast.

Some women have the option of a mastectomy or a lumpectomy (also called a breast-conserving surgery), and choose a mastectomy. For other women, a mastectomy is the only breast cancer surgery option.

With a mastectomy, the surgeon removes all the breast tissue. In most, but not all cases, the nipple and areola are also removed.

Learn more about the surgical procedure and what to expect after surgery.

Treatment for breast cancer

A mastectomy is an option for people who have:

A mastectomy is also used to treat breast cancer that has recurred (come back) after treatment with a lumpectomy plus radiation therapy.

Risk-reducing contralateral mastectomy

A risk-reducing (prophylactic) contralateral mastectomy is the removal of the opposite (contralateral) breast in a person who has breast cancer in only one breast. It’s usually done at the same time as breast cancer surgery, so both breasts are removed during the same surgery.

The goal of a risk-reducing contralateral mastectomy is to try and prevent breast cancer in the contralateral breast of women who have a very high risk of breast cancer. However, removing the contralateral breast does not lower the risk of dying from the original breast cancer [7].

The National Comprehensive Cancer Network (NCCN) recommends a risk-reducing contralateral mastectomy only be considered for women who have a very high risk of breast cancer due to an inherited gene mutation in one of these genes [8]:

  • BRCA1
  • BRCA2
  • CDH1
  • PALB2
  • PTEN
  • STK11
  • TP53

Cosmetic reasons for surgery to the contralateral breast

Sometimes, there may be cosmetic reasons to consider surgery to the contralateral breast. For example, some women may choose breast reduction to the contralateral breast to create a more even look with a reconstructed breast.

Learn more about breast reconstruction.

Risk-reducing bilateral mastectomy

Women with a BRCA1, BRCA2 or certain other inherited gene mutations who haven’t been diagnosed with breast cancer, may have both breasts removed to try to prevent breast cancer. This is called a risk-reducing bilateral mastectomy.

Learn more about a risk-reducing bilateral mastectomy.

Types of mastectomy

There are 2 main types of mastectomy: total (simple) and modified radical. Your diagnosis guides the type of mastectomy you will have.

The figure below shows the types of mastectomy and describes when each is used.

Total (simple) mastectomy

The surgeon removes the entire breast and the lining of the chest muscle, but no other tissue.

For some women, much of the skin of the breast may be left intact for breast reconstruction. This is called a skin-sparing mastectomy.

In some cases, the nipple may also be left intact. This is called a nipple-sparing mastectomy.

A sentinel node biopsy may be done, or no lymph nodes may be removed, depending on the breast cancer.

A total (simple) mastectomy may be used to treat:

  • Ductal carcinoma in situ (DCIS)
  • Paget disease of the breast with underlying DCIS
  • Invasive breast cancer
  • Breast cancer recurrence

A total mastectomy is also used for women at high risk who have risk-reducing mastectomy.

Sometimes breast reconstruction is done at the same time as a mastectomy.

Modified radical mastectomy

The surgeon removes the entire breast, the lining of the chest muscles and the lymph nodes in the underarm area (axillary lymph nodes).

A modified radical mastectomy may be used to treat:

  • Invasive breast cancer
  • Inflammatory breast cancer
  • Paget disease of the breast with underlying invasive breast cancer

Sometimes, breast reconstruction is done at the same time as a mastectomy. With inflammatory breast cancer, breast reconstruction can’t be done at the same time as a mastectomy. However, it may be done at a later time.

Skin-sparing mastectomy and nipple-sparing mastectomy

If you’re having breast reconstruction at the same time as a mastectomy, the surgeon may be able to use a skin-sparing technique, or possibly a nipple-sparing technique.

A skin-sparing mastectomy removes all the breast tissue but saves much of the skin of the breast. The plastic surgeon can use this skin as an envelope to help form the reconstructed breast.

A nipple-sparing mastectomy is a skin-sparing mastectomy that also preserves the nipple and areola.

Mastectomy with breast reconstruction

Some women choose to have breast reconstruction to help restore the look of the breast that was removed.

Reconstruction may be done at the same time as the mastectomy (immediate) or at a later time (delayed). In general, cosmetic results are better with immediate reconstruction.

Discuss your reconstruction options with your plastic surgeon before breast surgery.

Not all women choose to have reconstructive surgery. Some women choose to get a breast prosthesis. Others choose to have a flat closure (“go flat”).

Visit the FORCE website for a photo gallery of images of people who have had breast reconstruction after a mastectomy.

Learn more about breast reconstruction.

Learn about insurance coverage and financial assistance for breast reconstruction

Mastectomy with breast prosthesis

If you don’t have breast reconstruction, you can get a breast prosthesis that best fits your lifestyle. This is a breast form made of silicone gel, foam or other materials that’s fitted to your chest. It’s usually worn in a special bra.

The form is placed directly on top of your skin with a stick-on patch, or it’s placed in the pocket of a special bra.

The surgeon will leave the area as flat as possible so the prosthesis can be comfortably fitted to your chest.

Your prosthesis can be properly fitted to you several weeks after your mastectomy surgery.

Your health care provider can discuss your breast prosthesis options with you.

Visit the FORCE website for a photo gallery of images of people after a mastectomy.

Learn about insurance coverage for breast prosthesis and financial assistance for breast prosthesis.

Breast prosthesis and air travel

Susan G. Komen® wants to make sure people who have breast cancer are treated with respect and dignity.

When you travel by air, these steps may be helpful:

  • Arrive at the airport earlier than usual, so you have time to go through secondary screening if needed.
  • If you’re concerned about going through the body scanner for any reason, request a private pat-down screening.
  • If you choose, or are selected for, a pat-down screening, you may request a private screening away from public areas.
  • If you feel comfortable, tell the Transportation Security Administration (TSA) agent you are wearing a breast prosthesis. If you prefer to give this information discreetly, the TSA has a notification card you can give to the agent (find this card on the TSA website).
  • You will not be asked to remove your prosthesis, but you may be asked to lift or lower clothing to show your breast prosthesis in a private screening area. It’s OK for a companion or other person you choose to go with you to the screening area. A disposable drape will be available upon request. If you have concerns, you can remove your prosthesis before you go through security and put it through the X-ray screening in your carry-on.
  • If you feel uncomfortable for any reason, it’s always OK to ask to talk with a TSA supervisor.
  • It’s strongly advised you pack your breast prosthesis (if not wearing it) or medications in carry-ons, rather than in checked luggage.

Learn about TSA screening if you wear a wig, scarf or other head covering.

Learn about TSA screening if you wear a compression sleeve.

If you have concerns about airline security screening, visit the TSA website.

Mastectomy with a flat closure

If you don’t want to have breast reconstruction or use a breast prosthesis after a mastectomy, you can have a flat closure. This is also called going flat.

With a flat closure, the skin remaining after a mastectomy is tightened and smoothed to flatten out the chest wall as much as possible. However, the area will not be completely flat or smooth. How flat the area will be after surgery varies from person to person. There will also be a scar.

Talk with your health care provider about your surgery options. If you choose to go flat, talk with your surgeon before breast surgery.

Visit the FORCE website for a photo gallery of images of people after a mastectomy, including photos of people who have gone flat.

Read our blog, Despite What Doctors Told Me, I’ve Never Regretted My Decision to Go Flat After a Double Mastectomy.

Radiation therapy

Most women who have a mastectomy don’t need radiation therapy.

However, in some cases, radiation therapy is used after a mastectomy to treat the chest wall, the lymph nodes in the underarm area (axillary lymph nodes) and/or the lymph nodes around the collarbone.

If your treatment plan includes chemotherapy, you will have radiation therapy after you finish chemotherapy.

When is a lumpectomy plus radiation therapy an option to a mastectomy?

Some women can have a lumpectomy plus radiation therapy instead of a mastectomy.

Learn about deciding between a lumpectomy and a mastectomy.

Treatment guidelines

Although the exact treatment for breast cancer varies from person to person, evidence-based guidelines help ensure high-quality care. These guidelines are based on the latest research and agreement among experts.

The National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO) are respected organizations that regularly review and update their guidelines.

In addition, the National Cancer Institute (NCI) has treatment overviews.

Talk with your health care team about which treatment guidelines they use.

After you get a recommended treatment plan from your health care team, study your treatment options. Together with your health care team, make thoughtful, informed decisions that are best for you. Each treatment option has risks and benefits to consider along with your own values and lifestyle.

Transportation, lodging, child care and elder care assistance

You may not live near the hospital where you’ll have your surgery.

Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.

There are also programs to help you with child and elder care costs.

Learn about transportation, lodging, child care and elder care assistance programs

You’re not alone

If you’re facing breast cancer surgery, it’s normal to feel worried or afraid. Many people have been where you are today. They had the same fears and faced the same tough choices. They’ve gone through breast cancer treatment, recovered and are living their lives.

It may help to talk with others who’ve finished treatment to help ease your fears. You can do this in a support group or by connecting one-on-one with another breast cancer survivor.

You can also talk with your health care providers about how you’re coping. They care about your overall well-being and can help you find ways to improve it. In addition to suggesting a support group, they may connect you to another member of your health care team, such as a social worker or patient navigator, for support. They may also refer you to a counselor.

Our Support section has a list of resources to help you find local and online support groups and other resources.

Learn more about social support and support groups.

Learn about ways to cope with stress.

Susan G. Komen® Support Resources

Updated 06/29/23



Questions to Ask Your Doctor

Breast Cancer Surgery