Mastectomy is the medical term for the surgical removal of one or both breasts, either partially or completely. Dr Fosh can perform the appropriate mastectomy, depending on your individual cancer, its spread and your prognosis. These include a total, skin-sparing, nipple-sparing or partial mastectomy (also known as breast-conserving surgery).
In this procedure, all the breast tissue is removed, including the nipple and areola, using an elliptical incision approximately 15 centimetres long across the chest wall. Usually at the same time, either a sentinel lymph-node biopsy or total axillary-clearance is required to remove the lymph nodes from the armpit.
A total mastectomy is usually recommended if:
This procedure can usually only be used when a breast reconstruction is planned to follow the mastectomy immediately. It requires most of the skin over the breast (other than the nipple and areola) to be left intact. Implants or tissue from other parts of the body are then used to reconstruct the breast.
Skin-sparing mastectomy has two clear advantages: it leaves less scarring and you can gain a more natural-looking reconstruction. From an oncological viewpoint, it can work just as well as a simple mastectomy, as the amount of breast tissue actually removed is the same.
Whilst this operation is not suitable for all patients, it is a good option if you’re undertaking risk-reduction surgery, as it can gain a better cosmetic result.
Like the skin-sparing procedure, nipple-sparing mastectomy is almost always performed in conjunction with an immediate breast reconstruction of some type.
Known in the past as a subcutaneous mastectomy, this procedure not only preserves the skin of the breast, but the nipple and areola too. In order to obtain a good cosmetic result, the incision is usually underneath the fold of the breast or at the side.
For those who carry the BRCA gene or have a strong family history of breast cancer, Beverley can offer wise and supportive counsel. When all the facts point to a high risk of cancer, some patients elect to have a preventive mastectomy, also known as a risk-reduction or prophylactic mastectomy. It’s a big decision. That’s why you need to know as much as you can and we will support your decision, whichever way you choose to go.
Mostly, breast-conserving surgery – also known as a partial mastectomy – is performed for invasive cancer or ductal carcinoma in situ and Dr Fosh will only remove as much of the breast as is deemed necessary.
To make the most of the remaining, healthy tissue and gain the most natural-looking post-operative result, Beverley uses oncoplastic surgical techniques. These combine the removal of cancerous tissue and the restoration of the breast to give its shape a natural appearance.
Beverley works closely with our plastic surgeons to achieve the best possible final result for you. When the reconstruction is being planned, she collaborates extensively to ensure we maximise the breast’s shape and form.