Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, women believed to be at high risk of breast cancer choose to have the operation as a preventive measure. Alternatively, some women can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy. The decision to perform a mastectomy to treat cancer is based on various factors, including breast size, the number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of tumor recurrences after lumpectomy and/or radiation. Outcome studies comparing mastectomy to lumpectomy with radiation have suggested that routine radical mastectomy surgeries will not always prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis, and operation. In most circumstances, there is no difference in both overall survival and breast cancer recurrence rate. While there are both medical and non-medical indications for mastectomy, the clinical guidelines and patient expectations for before and after surgery remain the same. Mastectomies may also be carried out for transgender men and non-binary people to alleviate gender dysphoria. When part of gender-affirming care, mastectomies are commonly referred to as "top surgery". Intersex men with gynecomastia may also choose to undergo mastectomies.
Mastectomy indications
Breast cancer Despite the increased ability to offer breast conservation techniques to those with breast cancer, certain groups may be better served by traditional mastectomy procedures including:
women who have already undergone radiation therapy to the affected breast women with 2 or more areas of cancer in the same breast that are too far apart to be removed through 1 surgical incision women whose initial lumpectomy along with (one or more) re-excisions has not completely removed the cancer women with certain serious connective tissue diseases such as scleroderma, which make them especially sensitive to the side effects of radiation therapy pregnant women who would require radiation while still pregnant (risking harm to the child) women with a tumor larger than 5 cm (2.0 in) that doesn't shrink very much with neoadjuvant chemotherapy women with cancer that is large relative to their breast size women who have tested positive for a deleterious mutation on the BRCA1 or BRCA2 gene and opt for a preventive mastectomy since they are at high risk for the development of breast cancer.
Other uses
Mastectomy has non-cancer medical uses as well, including cosmetic or reconstructive surgery. Intersex men with gynecomastia may be eligible for mastectomy, but minimally invasive surgical techniques also exist. Transgender men and non-binary people who have breasts may undergo a mastectomy as a gender-affirming surgery. Within the transgender community, double mastectomies are more commonly referred to as "top surgery".
Side effects Aside from the post-surgical pain and the obvious change in the shape of the chest and/or breast(s), possible side effects of a mastectomy include soreness, scar tissue at the site of the incision, short-term swelling, phantom breast pain (pain in the breast or tissue that has been removed), wound infection or bleeding, hematoma (buildup of blood in the wound), and seroma (buildup of clear fluid in the wound). If the lymph nodes are also removed, additional side effects such as lymphedema (swelling of the lymph nodes) may occur. Upper limb problems such as shoulder and arm pain, weakness, and restricted movement are a common side effect after breast cancer surgery. According to research in the UK, an exercise programme started 7–10 days after surgery can reduce upper limb problems.
Types
As of April 2026, there are several surgical approaches to mastectomy, and the type that a person decides to undergo (or whether they will decide instead to have a lumpectomy) depends on factors such as the size, location, and behavior of the tumor (if one is present), whether or not the surgery is prophylactic or preventative, and whether the person intends to undergo reconstructive surgery after the mastectomy. For trans people undergoing a gender-affirming mastectomy, the type of procedure chosen can also vary depending on the desired results, the scarring (or lack thereof), the recovery process, the person's desire for nipple sensation, and other different factors based both on personal preference and input from medical experts.
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