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Mastectomy and breast reconstruction - what to ask your doctor

Mastectomy - what to ask your doctor; Breast reconstruction - what to ask your doctor; TRAM flap - what to ask your doctor; Latissimus dorsi flap - what to ask your doctor; What to ask your doctor about mastectomy and breast reconstruction; Breast cancer - mastectomy - what to ask your doctor

You may be having a mastectomy. This is surgery to remove your breast. Most often, a mastectomy is done to treat breast cancer. Sometimes, it is done to prevent cancer in women who have a high risk of getting breast cancer in the future. You may also have breast reconstruction. This is surgery to create a new breast after mastectomy.

Below are questions you may want to ask your health care provider about mastectomy and breast reconstruction.

Questions

What is the best treatment for my type of breast cancer?

  • Do I need to have surgery or will other treatments work? Do I have a choice of what type of surgery to have?
  • What types of cancer treatment will I need before or after surgery? Will these treatments be different depending on the type of surgery I have?
  • Will one type of breast surgery work better for my breast cancer?
  • Will I need to have radiation therapy?
  • Will I need to have chemotherapy?
  • Will I need to have hormonal (anti-estrogen) therapy?
  • What is my risk of getting cancer in the other breast?
  • Should I have my other breast removed?

What are the different types of mastectomy?

  • How is the scar different with these surgeries?
  • Is there a difference in how much pain I will have afterward?
  • Is there a difference in how long it will take to get better?
  • Will any of my chest muscles be removed?
  • Will any lymph nodes under my arm be removed?

What are the risks of the type of mastectomy I will have?

  • Will I have shoulder pain?
  • Will I have swelling in my arm?
  • Will I be able to do the work and sports activities that I want to?
  • For which of my medical problems (such as diabetes, heart disease, or high blood pressure) do I need to see my primary care or other provider before my surgery?

Can I have surgery to create a new breast after my mastectomy (breast reconstruction)?

  • What is the difference between natural tissue and implants? Which choice will look more like a natural breast?
  • Can I have breast reconstruction during the same surgery as my mastectomy? If not, how long do I need to wait?
  • Will I have a nipple also?
  • Will I have feeling in my new breast?
  • What are the risks of each type of breast reconstruction?
  • If I do not have reconstruction, what are my options? Can I wear a prosthesis?

How can I get my home ready before I even go to the hospital?

  • How much help will I need when I come home? Will I be able to get out of bed without help?
  • How do I make sure my home will be safe for me?
  • What type of supplies will I need when I get home?
  • Do I need to rearrange my home?

How can I prepare myself emotionally for the surgery? What types of feelings can I expect to have? Can I talk with people who have had a mastectomy?

What medicines should I take the day of the surgery? Are there any medicines I should not take on the day of the surgery?

What will the surgery and my stay in the hospital be like?

  • How long will the surgery last?
  • What type of anesthesia will be used? Are there choices to consider?
  • Will I be in a lot of pain after surgery? If so, what will be done to relieve the pain?
  • How soon will I be getting up and moving around?

What will it be like when I go home?

  • What will my wound be like? How do I take care of it? When can I shower or bathe?
  • Will I have any drains to drain fluid from my surgical site?
  • Will I have much pain? What medicines can I take for the pain?
  • When can I start using my arm? Are there exercises I should do?
  • When will I be able to drive?
  • When will I be able to return to work?

What kind of bra or other support top should I wear? Where can I buy it?

Open References

References

Klimberg VS, Hunt KK. Diseases of the breast. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 34.

National Cancer Institute website. Breast reconstruction after mastectomy. www.cancer.gov/types/breast/reconstruction-fact-sheet. Updated February 24, 2017. Accessed April 6, 2023.

 

Review Date: 3/11/2023

Reviewed By: Debra G. Wechter, MD, FACS, General Surgery Practice Specializing in Breast Cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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