What is a Simple (Total) Mastectomy
Complete removal of the breast — a definitive answer, not a compromise.
Simple mastectomy (also called total mastectomy) is the surgical removal of the entire breast — all of the glandular breast tissue, and, in most cases, the nipple-areola complex — while the muscles of the chest wall underneath are left completely untouched. Unlike a modified radical mastectomy, a simple mastectomy does not routinely remove the axillary (underarm) lymph nodes, though a sentinel lymph node biopsy is often performed at the same time to check whether cancer has reached the nearest node.
It differs from breast-conserving surgery (lumpectomy), which removes only the tumour and a margin of surrounding tissue and usually requires follow-up radiation. Simple mastectomy is chosen when the tumour is too large relative to the breast, when disease is spread across multiple areas of the breast, when a patient carries a high-risk genetic mutation, or simply when a patient prefers a single, definitive surgery over breast conservation plus weeks of radiation.
What has changed the experience of mastectomy over the last two decades is reconstruction. Skin-sparing and nipple-sparing techniques, combined with implant or the patient's own tissue (flap) reconstruction, mean that for many suitable patients, breast shape can be restored in the very same operation as the cancer surgery — or closely staged afterward. Where the breast cannot be safely spared or reconstruction isn't advisable yet, staged reconstruction remains an option at any later point. Learn more about breast-conserving surgery or breast reconstruction options if you're comparing your choices.
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Complete tissue clearance — the entire breast gland is removed for a thorough, definitive result, reducing local recurrence risk.
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Muscle-preserving — chest wall muscles are left completely intact, which keeps shoulder and arm strength and mobility.
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Reconstruction in the same sitting — implant-based or flap-based reconstruction can often be performed immediately, in appropriate candidates.
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Lymph nodes usually spared — unlike a modified radical mastectomy, most axillary nodes are left in place unless a sentinel node biopsy shows spread.