A mastectomy is the surgical removal of an entire breast to treat or prevent breast cancer. While a mastectomy does not eliminate the possibility that cancer will develop or return, it does greatly reduce the likelihood. There are a number of physical and psychological risks associated with a mastectomy, ranging from complications at the wound site to chronic pain to body image concerns.
Wound Complications
Women who have mastectomies are at risk of developing complications around the wound site, both on the chest wall and underneath the arm (if lymph nodes are removed). Long-term scarring and skin loss can occur around the incision. There may also be bleeding beneath the skin into the area where the breast(s) used to be, which can lead to slow healing, infection or the need for another surgery to control the bleeding. It is also common for fluid to collect in the armpit, requiring a drain for removal, according to the National Institutes of Health (NIH).
Pain around the incision site is common, and some women may develop chronic pain---a condition known as post-mastectomy pain syndrome---that is believed to be caused by nerve damage during the surgery, according to the Washington Hospital Center.
Removal of lymph nodes can increase the risk for nerve damage, which can cause numbness or tingling on the interior of the arm and muscle weakness in the back and chest wall. Most women whose lymph nodes have been removed experience pain and stiffness in the shoulder that is sometimes accompanied by a stabbing pain or burning sensation, according to the NIH. Underneath the arm and in the chest where the breast(s) used to be, some women may also feel a sensation of pins and needles.
Lymphedema
Removal of lymph nodes under the armpit put women at higher risk of developing lymphedema---a swelling of the arm caused by the collection of an abnormal amount of fluid. According to the University of Virginia Health System, women who have had a mastectomy may develop lymphedema immediately after surgery, or not for months or years after the procedure. The type of lymphedema that develops just after surgery usually comes on acutely and is mild and temporary, but the most common type occurs 18 to 24 months post-surgery and develops slowly and painlessly. Another type of lymphedema that occurs approximately 4 to 6 weeks after surgery also comes on suddenly but is usually significantly more painful.
Psychological and Sexual Risks
According to the American Cancer Society, women who have had a mastectomy are at risk for developing psychological and sexual side effects after surgery. Physical changes can lead some women to feel self-conscious, depressed, anxious, less feminine and less comfortable being intimate with their partners. Results from a study published in a March 2003 issue of Plastic and Reconstructive Surgery indicate that even women who had breast reconstruction immediately following a mastectomy reported psychological distress and concerns over body image one year following reconstruction. It is important to discuss these concerns with your doctor, as there are many supportive treatments that may help.
General Surgery Risks
Mastectomies increase your risk for a number of potentially serious complications that are possible with any surgery. These risks include severe blood loss, blood clots, heart attack or stroke, breathing problems, infections that can spread to other parts of the body and reactions to anesthesia or other medications.
References
- University of Virginia Health System: Lymphedema Following a Mastectomy
- "Plastic and Reconstructive Surgery"; The Psychological Effect of Mastectomy With or Without Breast Reconstruction: A Prospective, Multicenter Study; DM Harcourt et al.; March 2003
- Washington Hospital Center: Post-Mastectomy Pain Syndrome
