Mastectomy is defined as the removal of the breast tissue. There are various types of mastectomy, and the type of mastectomy recommended depends on each individual case. The types of mastectomy procedures include:
Radical mastectomy or Halsted mastectomy was a common surgery in the past. In this procedure, the entire breast, along with the underlying chest wall muscles and lymph nodes are removed. It is a rare procedure and is now used to treat patients with advanced breast cancer. Radical mastectomy is deemed as the most disfiguring of all the mastectomy procedures, where only a little tissue is left under the skin.
This procedure involves the removal of the entire breast by making a 6 to 7-inch long elliptical cut starting from the inside of the breast, close to the breast bone, and continuing up and out (straight or obliquely) toward the armpit. Sometimes, this surgery also includes removal of the lymph nodes from the armpit and is called modified radical mastectomy.
Skin-sparing mastectomy is a type of mastectomy where the breast tissue is removed through an opening made around the nipple and areola. This technique preserves most of the breast skin, which is generally lost in traditional mastectomy. It offers the advantage of negligible scarring and provides the best option for immediate breast reconstruction. For reconstruction, the native skin envelope is used to optimize the breast contour, color and texture of the breasts.
In nipple-sparing mastectomy, the incision to remove the breast tissue is made in the fold of skin under the breast, to the side, or around the areola, where the cut cannot be easily seen after healing. Like SSM, nipple-sparing mastectomy is also performed in combination with immediate breast reconstruction.
In conclusion, the types of mastectomies differ in terms of the amount of skin removed.
Women who are genetically predisposed to breast cancer may choose to have preventive mastectomy, which is also known as prophylactic or risk-reduction mastectomy.