Mastectomy, Lumpectomy, and Radiation Therapy
All mastectomies include near-complete removal of the breast tissue. What type of mastectomy your cancer surgeon performs will influence your options for reconstruction.
Modified radical mastectomy is the most traditional and currently a less common technique. It removes the most skin with the breast tissue. The scar is longest and there can be very little skin to work with.
Skin-sparing mastectomy is the most commonly performed technique. This spares all the breast skin except for the nipple and areola, which are removed with the breast tissue. There is good preservation of the overall shape of the breast, but the missing areolar skin usually requires that steps be taken to restore that skin during reconstruction. Scars are minimized.
Nipple-sparing mastectomy is uncommonly done, but may be a good choice for some patients. It consists of removal of the breast tissue, but spares all the breast skin, including the nipple and areola
Lumpectomy with Radiation Therapy
A lumpectomy is the procedure for removing the breast tumor without removing the entire breast (ie mastectomy). In the treatment of breast cancer it is usually used in conjunction with radiation treatments for the remaining breast tissue. In many cases the result is a normal appearing breast, but in some cases deformity can result from the loss of tissue, or from scarring and related to the radiation therapy. Reconstruction can be difficult after radiation therapy, and flap reconstruction is best. If it looks as though the lumpectomy may deform the breast, and the breast is large or sagging, then immediate lumpectomy reconstruction – oncoplastic surgery – may be performed. This means the breast is reshaped using the remaining breast tissue in the same fashion that might be used in a breast reduction or breast lift (mastopexy).