A modified radical mastectomy is a cancer-treatment procedure that removes the entire breast, including the skin, areola and nipple, and most axillary lymph nodes. Unlike radical mastectomy, the most invasive type of mastectomy, the muscles beneath the breast are not removed. A modified radical mastectomy is performed to remove the cancerous tumor, and any breast and lymph tissue that the cancer may have spread to. Modified radical mastectomy was once the primary surgical treatment for breast cancer, but as more has been learned about treatment outcomes, breast-conservation surgery followed by radiation therapy has become the standard.
Candidates for Modified Radical Mastectomy
Studies have shown that the survival rate is the same whether treatment consists of partial mastectomy followed by radiation therapy, or the removal of the entire breast. There are, however, situations in which partial mastectomy is not an appropriate treatment. In those cases, and those in which a woman feels more secure about the cancer's not recurring by having the entire breast removed, modified radical mastectomy may be an option. Candidates for modified radical mastectomy include those who have:
- Two or more tumors in different areas of the breast
- Had previous radiation treatment to the breast and the cancer has recurred
- Cancer present, following lumpectomy, at the edges of the area operated on
- A gene mutation that creates a high risk for a second cancer
- A large tumor relative to the breast's overall size
- A connective-tissue disease that makes side effects of radiation to the skin untenable
A pregnant women for whom radiation poses a risk to the fetus is also a candidate for modified radical mastectomy. And a woman without breast cancer, but who has a very high risk of developing it, may choose to undergo a double modified radical mastectomy as a preventive measure.
Risks Associated with Modified Radical Mastectomy
There are a number of risks associated with modified radical mastectomy. Some risks are associated with almost any surgery, and some are associated with modified radical mastectomy itself. Risks may include:
- Swelling in the arm
- Shoulder pain and stiffness
- Underarm numbness from lymph-node removal
- Formation of hard scar tissue at the incision site
- Blood buildup at the incision site
Mastectomy usually requires a one- to three-day hospital stay, but some women may be able to go home the same day. A drain, which will be removed approximately two weeks later, may be attached to the chest to collect fluid.
Additional Treatment After Modified Radical Mastectomy
To decrease the chances of a recurrence of breast cancer, additional types of treatment may be recommended post-mastectomy. Treatments may include:
- Radiation therapy
- Hormone therapy
- Targeted therapy
Breast Reconstruction After Modified Radical Mastectomy
After undergoing modified radical mastectomy, many women opt for breast reconstruction. The goal of reconstruction is to match the appearance of the other breast, and to eliminate the need for an external prosthesis. Reconstruction may involve a breast implant or skin grafts, and can be performed at the same time as the mastectomy or at a later date.