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The procedure involves removing the entire breast (all of the mammary gland, areola and nipple). It is most often combined with sentinel lymph node biopsy or Axillary dissection.
Mastectomy is necessary in around 30% of breast cancer cases.
Indicating a mastectomy is not linked to the severity of the cancer but to its size.
Some small but aggressive cancers are treated using conserving surgery while others that are not very aggressive but are diffuse may require a Mastectomy.
Most often, the resection is slanted, in the shape of an ellipse. As far as possible we avoid making high incisions so that the scar is not visible in the décolletage. The result is a straight scar, slightly slanted upward and outward, as well as the loss of the breast mound. The scar might be different in the case of immediate breast reconstruction.
The scar is often inconspicuous.
What is a simple or total mastectomy ?
It is a Mastectomy without axillary lymph node dissection. It is possible in the following cases :
- non-invasive intraductal carcinoma ;
- lrecurrence after a breast-conserving treatment ;
- prophylactic (preventive) mastectomies.
What is a skin-sparing mastectomy ?
This technique involves keeping all the skin of the breast, except for the areola and the nipple. It is used in the case of Mastectomy combined with immediate breast reconstruction, on breasts that are not too large in size. The incision is therefore made around the areola, sometimes with a little extension towards the side in order to remove the mammary gland, while keeping the skin for the reconstruction.
This technique is not possible for all types of cancers.
What is a nipple-sparing mastectomy ?
In this case, all of the breast skin is conserved, including the areola and the nipple. This technique is mainly used in the case of a prophylactic (preventive) mastectomy but it is starting to be recommended for some cancers. However, after the histological examination, if the cancer is judged by the pathologist to be too close to the areola, a new procedure may be recommended for removing the areola and nipple.