Skin-Sparing Mastectomy

Mastectomy is the surgical removal of part or all of the breast tissue. This operation is generally preferred in the treatment of breast cancer. The types of mastectomy applied include different techniques such as simple mastectomy, modified radical mastectomy, partial mastectomy, and segmental mastectomy. Lumpectomy, which is a more limited method, is restricted to the removal of only the area where the tumor is located. After surgery, reconstruction surgery can be performed to reshape the breast. In breast reconstruction, silicone implants or the person's own body tissues can be used.

The post-mastectomy process requires not only physical but also psychological support. During this period, the use of breast prostheses is an important alternative, especially for patients who do not undergo reconstruction. Mastectomy bras, specially designed for women who have had a single breast removed, provide both balance and comfort. Additionally, silicone reconstruction surgery plays an important role in restoring the aesthetic appearance. The recovery process may show individual differences; it is generally completed within a few weeks. During this period, the risk of lymphedema after mastectomy should be considered, and this risk should be reduced with regular exercises.

The experiences of individuals undergoing mastectomy reflect both the physical and emotional aspects of the operation. In the post-operative period, the risk of recurrence of the disease is attempted to be reduced with regular check-ups. Possible complications include conditions such as infection, pain, fluid accumulation, and lymphedema. Additionally, the disability rate that may occur after mastectomy in some patients can affect the quality of life.

The cost of mastectomy surgery may vary according to the surgical method applied, the equipment of the center, and the expertise of the team performing the operation. Making a personal plan for each patient is of great importance for treatment success.

What is Mastectomy and Why is it Performed?

Mastectomy is an operation in which part or all of the breast tissue is surgically removed, generally preferred in the treatment of breast cancer. This procedure aims to remove cancerous cells or tissues at risk of turning into cancer from the body. While in some cases removing only a specific area (for example, partial mastectomy or lumpectomy) is sufficient, if the size of the tumor is large or if there is spread in more than one focus, mastectomy, which is a more comprehensive operation, is applied.

Breast cancer is a disease where cells multiplying uncontrollably form tumors and can spread to surrounding tissues or distant organs. Especially genetic factors such as BRCA1 or BRCA2 gene mutations can significantly increase the risk of contracting cancer in individuals. In this case, the decision for preventive mastectomy taken before cancer develops can reduce the risk by 90-95%. We can think of this application like strengthening or renewing a structure that is likely to cause problems in the future; the potential danger is eliminated before it even arises.

Some patients may prefer to have a mastectomy due to personal concerns, even if there is no medical necessity. This option can be evaluated especially for individuals who are not suitable for radiotherapy or who are worried about the recurrence of the disease. For example, while applying radiotherapy during pregnancy may be inconvenient, radiotherapy may not be possible again in a patient who has previously received radiation therapy in that area. In such cases, mastectomy becomes a safer choice instead of limited surgery. Again, depending on the biology of some tumors, mastectomy may be preferred to reduce the possibility of future recurrence.

What are the Different Types of Mastectomy Surgery?

The type of mastectomy to be applied for each patient varies according to the size of the tumor, the level of spread, the general condition of the patient, and aesthetic expectations. Each of the surgical techniques aims to remove the cancerous tissue safely and, when necessary, to preserve a suitable area for reshaping. Here are the most commonly applied types of mastectomy:

Total (Simple) Mastectomy

In this method, the entire breast tissue, the nipple, and the areola (the dark circle around the nipple) are removed. Chest muscles are generally preserved, and axillary lymph nodes are not routinely intervened. However, depending on the size of the tumor or suspicion of lymph spread, a sentinel lymph node biopsy may be performed.

Modified Radical Mastectomy

In this technique, in addition to total mastectomy, axillary (underarm) lymph nodes are also removed. If there is a risk of cancer jumping to the lymph system, this procedure becomes mandatory. The aim is to prevent the spread of the disease and to completely clean the cancerous tissue in the area.

Radical Mastectomy

In this method, which was widely performed in the past, part of the pectoral muscles is also removed along with the breast tissue. Today, it is only applied in very advanced stages because it causes unnecessary tissue loss. Since similar oncological successes can be achieved with modern techniques, it is now rarely preferred.

Skin-Sparing Mastectomy

In this approach, a large part of the skin is preserved while the breast tissue is removed. The nipple and areola are usually removed, but a structure suitable for reconstruction (reshaping) procedures is provided by preserving skin integrity. In this way, aesthetically more satisfactory results are obtained.

Nipple-Sparing Mastectomy

Similar to the skin-sparing method, the nipple and areola are also left in place in this technique. However, for this, the tumor must not be close to the nipple, and it must be pathologically verified that there are no cancerous cells in this area. It can be applied especially in patients who want to preserve their natural appearance from a cosmetic point of view.

Bilateral Mastectomy

This is the process of removing both breasts at the same time. It is applied in individuals with a genetic predisposition or who carry a risk of cancer in the other breast as well. It is also preferred for patients diagnosed with unilateral cancer but in whom a high risk has been detected in the other breast.

Prophylactic (Preventive) Mastectomy

This is performed in individuals who carry a high risk due to genetic factors, although cancer has not yet developed. This operation significantly reduces the possibility of future cancer. In a way, it is like strengthening the foundation of a building to prevent a possible disaster; it eliminates the risk at its root.

Which Tissues are Removed During Mastectomy?

The primary goal of the mastectomy operation is to completely clean the breast tissue that is cancerous or carries a risk of cancer. The surgeon meticulously removes all diseased structures during this procedure. The following tissues are removed during surgery:

Breast Tissue (Glandular Structure)

The breast consists of lobules responsible for milk production, milk ducts, and the surrounding fat and connective tissues. During mastectomy, these glandular structures and surrounding supporting tissues are removed as a whole.

Nipple and Areola

In classic or total mastectomy applications, the nipple and the surrounding areola tissue are also removed. However, in techniques called "nipple-sparing mastectomy," these structures can be preserved if the location and condition of the tumor are found suitable.

Skin

In some types of mastectomy, especially in total mastectomy, a large part of the breast skin is removed. In skin-sparing mastectomy applications, as much skin tissue as possible is left, and only unnecessary areas are surgically removed.

Axillary Lymph Nodes

If there is a suspicion of tumor spread in the lymph nodes or if a modified radical mastectomy is planned, the surgeon performs a sentinel lymph node biopsy or axillary lymph node dissection in the same session. This procedure is usually done along with the mastectomy and helps evaluate the degree of spread of the disease.

The Role of Lymph Nodes in Mastectomy Surgery

Lymph nodes are known as small structures that act as "filters" in the body's immune system. Lymph fluid coming from the breast area first passes through these nodes. Cancer cells can spread by accumulating in these filters. Therefore, the status of the lymph nodes is always evaluated during mastectomy.

Sentinel Lymph Node Biopsy

With this method, the "pioneer lymph node" that cancer cells can reach first is determined. A special dye or radioactive substance is injected into the tumor area, and the lymph node that holds this substance is removed and examined. If no cancer cells are detected in this sentinel node, the possibility of spread to other nodes is generally considered low, and wider dissection is not necessary.

Axillary Lymph Node Dissection

If tumor cells are detected in the sentinel node or if the tumor size is large, a more comprehensive lymph node cleaning is performed. In this procedure, the first and second-level lymph nodes are removed and sent for pathological examination. Thus, the stage of the disease is determined, and precautions are taken to reduce the risk of recurrence.

One of the most common complications after the removal of lymph nodes is lymphedema. This condition manifests itself with swelling, hardness, and sometimes pain in the arm area as a result of the accumulation of lymph fluid. Performing regular arm exercises, applying lymphedema massage, and adopting appropriate prevention methods in the post-operative period significantly reduce this risk.

Basic Stages of the Mastectomy Surgical Process

Mastectomy surgery is a surgical procedure that requires detailed preparation and high attention. The basic steps of the operation generally proceed as follows:

General Anesthesia Application

Before the surgery begins, general anesthesia is applied to the patient. During this process, vital functions such as respiration and heart rhythm are continuously monitored.

Surgical Marking

The surgeon marks the location of the tumor and the boundaries of the tissues to be removed on the skin before the operation. This process helps prevent damage to an off-target area during surgery.

Opening the Incision and Tissue Separation

An appropriate incision line is created according to the determined type of mastectomy. The surgeon carefully separates the breast tissue under the skin from the muscle fascia. Meanwhile, bleeding control is continuously ensured, and tissues are removed in a planned manner.

Evaluation of Lymph Nodes

If a sentinel lymph node biopsy is to be applied during the surgery, the lymph node previously marked with dye or radioactive material is found and removed. If a modified radical mastectomy is to be performed, axillary lymph node dissection is carried out in the same session.

Bleeding Control and Drain Application

Bleeding vessels are stopped with surgical cautery or suturing methods. A drain is placed to prevent fluid accumulation after the operation. These drains support the healing process by transferring the fluid in the surgical area outward.

Closing and Dressing

All tissues are sutured layer by layer, and skin edges are closed with special sutures or a stapler system. A sterile dressing is applied over it. Drain ends usually come out from the skin edge and are connected to a bag or vacuum system.

Waking Up Process and Initial Controls

When the surgery ends, the patient is kept under observation in the waking room to emerge from the effects of anesthesia. At this stage, pulse, respiration, and blood pressure values are carefully followed. The patient, whose condition becomes stable, is taken to the ward for observation.

How Does the Post-Mastectomy Recovery Process Proceed?

The recovery process after mastectomy consists of several stages, and each individual's healing experience may differ. On average, basic wound healing is completed within the first 3 to 6 weeks; then, a longer period of physical and psychological rehabilitation begins.

Hospital Stay and First Days

Usually, patients are discharged the very next day after surgery, although this period can sometimes extend to a few days depending on the patient or complications. This duration may vary according to the scope of the operation and the general health status of the patient.

The drains placed to prevent fluid accumulation in the surgical area remain until the amount of fluid decreases. In most cases, they are removed within a week, but this period may be longer in some patients.

Pain Control and Movement Restrictions

It is natural to feel pain in the post-operative period. During this process, pain relievers and muscle relaxant medications can be used to reduce pain.

It is recommended not to move the arms suddenly in the first days and not to carry loads. Light exercises started with doctor's approval support healing by increasing circulation.

Dressing and Suture Care

According to the type of suture used, sutures can be removed between 7–14 days or may disappear by dissolving on their own.

Dressings in the surgical area should be renewed regularly, and the health team should be notified when redness, discharge, or an increase in temperature is noticed at the wound line.

Physical Therapy and Rehabilitation Period

To prevent swelling in the arm (lymphedema), it is recommended to perform regular exercises and light massages under the guidance of a physiotherapist.

If axillary lymph nodes were removed during the surgery, special movements and therapies that support the circulation of this area should be applied.

Return to Daily Life

The majority of patients can return to light work and desk-based duties within 4 to 6 weeks. However, heavy lifting, sports that strain the arm, or sudden movements should be restricted for a while longer.

Driving is usually possible within 2–3 weeks after surgery, but this depends on personal healing speed and pain levels.

Mental Support and Psychological Process

Mastectomy can cause significant changes in a person's physical appearance. This situation can lead to temporary fluctuations in self-confidence and body perception.

Receiving psychological counseling, participating in group therapies, or communicating with support groups during this process positively affects mental healing.

What are the Possible Complications of Mastectomy?

As with every surgical procedure, mastectomy carries some complication risks. These risks are generally at a low rate, but informing the patient is important.

Bleeding and Hematoma

Due to vascular damage after surgery, blood can collect under the skin. While this situation sometimes resolves on its own, in some cases, the fluid may need to be drained.

Seroma (Fluid Accumulation)

Following extensive tissue removals, the body may fill the vacant spaces with fluid. Drains reduce this risk, but it is possible for seroma to develop even after the drains are removed.

Infection Risk

Symptoms such as increased temperature, redness, or discharge in the surgical area may be heralds of infection. In this case, antibiotic treatment or surgical cleaning may be required.

Delay in Wound Healing

Conditions such as smoking, diabetes, or obesity can slow down wound healing. In these patients, the risk of tissue necrosis is higher, and extra dressing or a second intervention may be required.

Lymphedema (Swelling in the Arm)

In patients where axillary lymph nodes have been removed, swelling and hardness can develop in the arm area as a result of the disruption of lymph flow. This condition can become chronic; it can be controlled with special exercises, massage, and compression garments.

Nerve (Neurological) Damage

During the surgical procedure, some nerves are consciously cut. However, although some nerve structures are attempted to be preserved, they can sometimes be damaged or may necessarily need to be removed. In these cases of nerve damage, it can cause numbness, tingling, or loss of sensation in the arm. Loss of function in some back muscles innervated by the nerve can be seen.

Aesthetic and Mental Effects

Removal of the breast can create significant changes in an individual's body image and mental balance. During this period, aesthetic reconstruction options and psychological support services increase the quality of life of patients.

Differences Between Mastectomy and Breast-Conserving Surgery

Breast-conserving surgery and mastectomy represent different surgical approaches in the treatment of breast cancer. While in breast-conserving surgery only the tumor area and a small amount of healthy tissue around it are removed, in mastectomy, the entire breast tissue is taken.

Surgical Scope

Breast-conserving surgery is a more limited surgical procedure, and the majority of the breast is preserved. Mastectomy involves the removal of all breast tissue and is considered a wider operation.

Visual and Aesthetic Results

The general shape of the breast can be preserved after breast-conserving surgery; however, the size or location of the tumor can affect the aesthetic result. In mastectomy, the entire breast is removed, and reshaping can be done with reconstruction if desired.

Requirement for Additional Treatment

Breast-conserving surgery is usually supported by radiotherapy. After mastectomy, radiotherapy is applied only in certain situations (for example, lymph node involvement).

Risk of Recurrence and Lifespan

In early-stage breast cancers, survival rates are similar between the application of breast-conserving surgery + radiotherapy and mastectomy. Some patients prefer minimal surgery, while others may choose mastectomy due to concern about recurrence.

Suitability According to the Patient

Which method will be chosen is determined according to the size and location of the tumor, whether there is more than one tumor focus, genetic risk factors, and the patient's personal preferences.

The goal is both to ensure treatment success and to protect the patient's quality of life.

What Role Does Mastectomy Play in Preventing Breast Cancer?

Mastectomy is a surgical method that can be applied not only in the treatment of existing breast cancer but also to reduce the risk of developing cancer. Such applications are called protective (prophylactic) mastectomy. Prophylactic mastectomy is preferred in individuals who have not yet contracted cancer but are in the high-risk group due to genetic or familial reasons.

People in the High-Risk Group

The probability of developing breast cancer is quite high in some people due to genetic mutations. Especially in individuals carrying BRCA1 and BRCA2 gene changes, the lifetime risk of contracting breast cancer is much higher than in the normal population.

Additionally, people who have more than one breast cancer case in their first-degree relatives or individuals with hereditary cancer syndromes are also included in the high-risk group. In these people, mastectomy comes up as an option to prevent cancer formation.

Bilateral Prophylactic Mastectomy

Removing both breasts for protective purposes can statistically reduce the risk of developing breast cancer by approximately 90–95%.

However, this decision is not made easily; because removing both breasts while the person has not yet contracted cancer can create a serious psychological burden. Still, for some individuals, eliminating the fear of contracting cancer in the future makes choosing this surgery logical. Detailed evaluations made with specialist support during this process help the patient make the right decision.

Reconstruction Options

Many patients undergoing prophylactic mastectomy may prefer to have breast reconstruction in the same session or at a later period.

Thanks to skin-sparing or nipple-sparing surgical techniques, both results close to a natural appearance can be obtained and the psychological effects of the operation can be reduced. These applications contribute to the person feeling better and preserving their body perception.

Alternative Protective Approaches

There are also some preventive strategies other than mastectomy for high-risk individuals. These include regular screening methods (for example, annual mammography, breast MRI, ultrasonography) and protective drug treatments (anti-estrogen drugs such as tamoxifen, raloxifene).

Although these alternatives increase the chance of early diagnosis, surgical removal of the breast tissue provides the most distinct reduction in risk.

Prophylactic Mastectomy Decision

Prophylactic mastectomy is a decision with strong personal and emotional aspects. Sometimes it can be thought of as "securing a structure in advance that is likely to be demolished in the future."

For this reason, the decision process should not be rushed; a comprehensive evaluation should be made accompanied by genetic counseling, psychological support, and specialist physician opinions.

Although this operation does not completely prevent cancer development, it can increase the individual's quality of life and psychological peace by significantly reducing the risk of disease.

Use of Prosthesis and Bra After Mastectomy

Prostheses and specially designed bras used after mastectomy are very important both for balancing the physical appearance and providing psychological relief. For individuals who do not undergo breast repair, external prostheses help maintain body balance and allow clothes to look more aesthetic. These prostheses are usually produced from silicone, foam, or light medical materials and are designed in various shapes and sizes suitable for every size.

Mastectomy bras were developed to stabilize the external prosthesis and to provide support without damaging the sensitive chest area after surgery. The difference between these bras and classic bras is that they have wide bands, inner pockets, and design details that provide extra support. Since usage comfort is prioritized, they are produced from soft, breathable fabrics that do not irritate the skin.

Choosing the right bra and prosthesis increases the person's self-confidence and allows them to move comfortably in daily life. Deciding which model will be suitable based on the type of surgery and recovery status with expert advice is the healthiest approach.

What is Breast Reconstruction?

Breast reconstruction (breast re-creation surgery) performed after mastectomy is a surgical option that helps many women undergoing breast cancer treatment regain both their physical appearance and mental balance. This procedure aims to reshape the removed breast tissue and restores the body's natural balance.

Reconstruction surgeries can be roughly evaluated under two headings as simultaneous and delayed repairs.

Simultaneous repairs are types of repairs performed in the same session as the mastectomy. Delayed repairs, on the other hand, are repairs performed after the oncological treatment process is completed.

Prosthesis-Based Reconstruction

In this method, silicone or saline-filled implants are used to create a new breast shape. It usually consists of a two-stage surgical process. In the first stage, a tissue expander is placed; thus, the skin and muscle tissue are gradually stretched. Then, in the second operation, the expander is removed and a permanent implant is fitted. This method is frequently preferred because the surgical duration is short and the recovery period is faster.

Autologous Reconstruction (Flap Method)

In this technique, also known as the autogenous or flap method, a new breast shape is created using the person's own tissues. Fat, skin, and muscle tissues taken from the abdomen or back area are moved to the chest area to gain a natural breast appearance. Reconstruction performed with this method creates a more natural feel thanks to the tissue being alive and flexible. However, the healing process may be slightly longer than prosthesis-based methods.

When deciding on a reconstruction option, the person's general health status, the scope of the surgery undergone, additional treatments such as possible radiotherapy, and personal expectations should be taken into consideration. Determining the appropriate method ensures that both aesthetic and functional results are successful.

Mastectomy Surgery Prices

The price of mastectomy surgery may vary according to the surgical technique to be applied, the general health status of the patient, the equipment of the center where the operation will be performed, and the experience of the surgeon. Pre-operative tests, pathological examinations, the post-operative care process, and reconstruction (breast repair) procedures are also important elements affecting the total cost. Additionally, extra procedures such as aesthetic restructuring, use of silicone prosthesis, or tissue transfer can also be included in the prices.

To reach the most accurate and up-to-date mastectomy surgery price information, contacting the relevant health center directly ensures that a personalized cost planning is made.

Provinces Where We Provide Mastectomy (Removal of Breast) Surgery Service

Mastectomy surgery is carried out by experienced surgical teams with modern medical facilities. Pre-operative evaluation, surgical planning, aesthetic reconstruction options, and post-operative follow-up processes are carried out by prioritizing patient safety and satisfaction.

This comprehensive service is not limited to only one center; it is offered in a safe, professional, and ethical standard manner for patients coming from the provinces of Adana, Mersin, Osmaniye, and Hatay.

Patients who want to achieve permanent and aesthetically satisfactory results in the treatment of breast cancer can create their own treatment plans by obtaining detailed information about mastectomy surgery.