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Types of Mastectomies
Total mastectomy:
A total mastectomy involves removing as much of the breast tissue as possible. The nipple, the coloured skin around it (called the areola) and most of the skin covering the breast is also removed.
Skin sparing mastectomy:
This approach involves removing as much of the breast tissue as possible, as well as the nipple and areola. The skin that was covering the breast is preserved, making it easier to maintain the contour of the breast when reconstruction is done.
Subcutaneous mastectomy (skin/nipple sparing mastectomy):
In this procedure, as much of the breast tissue as possible is removed while leaving in place all the skin, the nipple (which contains breast ducts) and the areola. While subcutaneous mastectomy gives the best cosmetic result, some breast tissue remains.
It is important to note that the surgery that gives you the best cosmetic outcome may not be the most effective at reducing your risk of developing breast cancer. It is important to discuss this point with the professionals you talk to when making your decision.
Can breast cancer risk be reduced or eliminated through having a mastectomy?
In theory, if all the breast tissue is removed, a woman’s risk of developing breast cancer should be eliminated. In practice, in a total mastectomy all the breast tissue that can be seen by the surgeon is removed. Unfortunately, it is very difficult to remove every single breast cell, so there is still a small risk of developing breast cancer after a mastectomy as there may be some remaining breast tissue. In a subcutaneous mastectomy, since the nipple and some breast tissue are left behind, the risk of developing breast cancer has not been reduced as much as it could have been by total mastectomy.
Above is a video of Christina Applegate who is BRCA1 positive and had a preventive mastectomy due to DCIS.
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