Mastectomy is a surgical procedure that partially or fully removes the breasts. Its goal is to treat breast cancer. Sometimes the treatment may be offered to patients with a high risk of breast cancer as a way to prevent such an occurrence. If you need more information about mastectomy in Singapore, as in recovery, cost, candidacy, and more, continue to read down the paragraphs.

Types of mastectomy (surgery for breast cancer)

  • Simple mastectomy. This one cuts out everything from the breast skin to the areola, nipple, part of the muscles under the breast, and fat deposits. In addition to the removal of the breast tissue, some underarm lymph nodes (axillary lymph nodes) might have to be eliminated as well. Just so you know, it also goes by the name of total mastectomy.
  • Modified radical mastectomy. This one is like the above operation but it spares the pectoralis major muscle (chest muscle). It’s one of the first approaches surgeons used to treat breast cancer in the past.
  • Double mastectomy (preventive mastectomy). This type is performed on women who don’t have breast cancer yet but are at extremely high risk of getting it. It removes both breasts and is said to reduce the risk by 95%.
  • Radical mastectomy. This is the most severe type of mastectomy and it’s not very common these days. In this treatment, the surgeon goes for the chest muscles, axillary lymph nodes, removing the entire breast.
  • Skin-sparing mastectomy. Here, the surgeon gets rid of the nipple and areola, as well as some breast tissue. The skin is left unscathed. It makes enough room for an implant should the patient be down for a breast reconstructive surgery. However, it doesn’t work for larger tumours or tumours that are positioned close to the surface. It goes without saying that the majority of women opt for skin-sparing mastectomy because it creates less scar tissue.
  • Nipple-sparing mastectomy. Here, the chest wall muscles, nipple and skin are spared, only the breast tissue is removed. The technician works below the areola. Now, this type of mastectomy is suitable for people with early-stage breast cancer that is pretty manageable. If cancer has spread to other areas, other techniques will be adopted.

Mastectomy vs Lumpectomy

Lumpectomy is a partial mastectomy, more commonly dubbed breast-conserving surgery (BCS). It aims to remove the tumour only and as little tissue as possible. What this does is leave the breast looking almost the same as before without putting an unnecessary aesthetics burden on the patient. You should know that not every person is eligible for a lumpectomy.

Invasive breast cancer is when the tumour has grown into adjacent areas, including the lymph nodes. Its most common forms are invasive lobular carcinoma and invasive ductal carcinoma. As far as treatment is concerned, it often requires a combination of simple mastectomy (or total mastectomy) and other therapies.

What stage of breast cancer requires a mastectomy?

senior womans after partial mastectomy

In most cases, stages one and two of breast cancer will require either a mastectomy or a breast-conserving surgery paired with radiation therapy. Other procedures may be offered to the patient.

In this day and age, there is more than one breast cancer treatment. The options depend on how fast the tumour is growing and if it has already spread to other areas, as well as if it contains hormone receptors. Other factors that will influence your choice of treatment for breast cancer include your overall health, your age, and if the tumour is HER2-positive.

Finally, if you are in menopause, that’s another thing to take into account for your journey to recuperation. Overall, there is hormone therapy, surgery, chemotherapy, and radiation therapy, to name a few. They all have side effects and carry risks.

Who is suitable for a mastectomy?

These days, more and more doctors, and patients themselves prefer breast-conserving surgery to mastectomy. However, some women are recommended to undergo mastectomy procedures, especially if they:

  • Have multiple lumps in one breast that are positioned far away from each other
  • Have already done breast-conserving surgery to no avail (breast cancer cells are still to be found under the skin)
  • Would rather not have to deal with radiation therapy
  • Are not able to undertake radiation therapy because of sensitivity to it or other issues
  • Present with inflammatory breast cancer
  • Are genetically predisposed to getting breast cancer (usually due to a BRCA1 or BRCA2 mutation)
  • Have ductal carcinoma in situ (DCIS)
  • Are pregnant and radiation therapy is not an option

Discuss your options with a specialist and see if you would make a good candidate for mastectomy. If that’s not what you want, talk about the possibility of getting a BCS.

What happens on the day of the breast cancer surgery

When you go to the hospital for your surgical intervention, you will be ushered into the preoperative area and instructed to change into a gown. While you are waiting, you will probably be allowed to have a family member or friend with you.

A nurse will prep you for the treatment by marking your breasts. You will go to the anaesthesia room to receive relaxing medication and will then head for the operating room. General anaesthesia will be administered and you will fall into a deep sleep.

The surgeon starts by making an incision into the breast, typically around the areola or the place where a biopsy was executed. They remove all the tissue from the breast that was intended to go. Axillary lymph node dissection or sentinel node dissection might be performed as well.

Before the end of the surgery, there is an extra step that may or may not be carried out. It’s breast reconstruction. If it’s part of the plan, the specialist will go through with it, making sure the new breast looks identical to the other. In the case of a double mastectomy, the specialist will work on both breasts.

With or without this step, the affected area has to be checked for bleeding and other problems that could arise during such a manipulation. The operator will place drainage tubes inside the breasts to let out any fluids that will accumulate afterwards. All incisions will be stitched back.

What happens after a mastectomy

After your breast removal surgery, you will wake up in the recovery room. While you are there, the staff will monitor your blood pressure, body temperature, and heart rate to ensure your body is handling the surgery well. When your vital signs are stable enough, you will be moved to a hospital room to continue your recovery.

You will spend about three days in the hospital or clinic. Before you are discharged, the staff will show you specific exercises you can do to avoid shoulder stiffness. You should perform this routine at home for some time. It is important to understand that some of your movements will be restricted and you have to be careful not to pop open your stitches. Also, you had better not carry out some of the exercises with the drains in. Listen to the nurses and physiotherapists and you will be fine.

Mastectomy surgery recovery time

In most cases, four to six weeks will pass before you regain strength and go back to your normal self. Your mastectomy recovery starts at the hospital and continues back in your house where you will have to implement a series of steps to care for the wound.

To begin with, the bandage should not be exposed to water and you have to do your best to keep it dry at all times. This will keep infection at bay. If you still have your drain inserted into your breasts when you get back home, you will need to adhere to the doctor’s instructions on how to release the fluids that have accumulated.

The medical staff should have told you how to spot an infection and what to do if such occurs. More information on that is available online. You want to watch out for the signs more vigilantly during the first 72 hours. If you notice something unexpected going on, do not hesitate to call the office.

In the meantime, feel free to take medication to manage the discomfort and pain that normally ensue after surgery. Unless the physician writes a prescription, stick with OTC medicine. Since your condition will probably hamper you from making a trip to the drugstore, ask a family member to take care of that for you.

Now, what about stitches? In most cases, dissolvable sutures are used. This means that the body absorbs them over time and there is no need to book a follow-up appointment to have the job tackled. If instead staples are employed to close the wound, they will be taken out on your next visit to the hospital or clinic. Ask when the right time is to start wearing a bra or breast prosthesis.

How to make a good recovery after breast cancer surgery

  1. Don’t be too harsh on yourself. Mastectomies are awful. You’ve just had a tiresome experience that has put on a lot of stress over your body. Right now all you need is rest. Plenty of rest. Give yourself a break to allow enough time for the body to recuperate. Avoid tedious physical work. Ask a friend or relative to do the heavy chores for you like shopping, laundry, cooking, and childcare. The best indicator that you’re pushing yourself to the limit will be your body. Monitor how you feel and act accordingly.
  2. Follow your exercise regimen. Remember that your doctor recommended exercising your arms to avoid problems with your shoulders and slowly ease yourself into the normal range of motion? You have to stick with that for as long as necessary, be it weeks or months. Not only will it make you feel better but it will speed up recovery.
  3. Don’t take full showers until your drains and sutures have been removed. Immerse a sponge in soapy water and run it over your body, making sure to bypass your chest and shoulders. This will keep you fresh for the time being or until you are allowed to take baths.
  4. Take your medication as instructed. Other than painkillers, your doctor might also direct using antibiotics to counteract infection and inflammation after mastectomy. Consult them before downing any other medicament that was not in the prescription. Wait for the specialist to tell you when you can come off the drugs.

Cost of Mastectomy and Breast Surgery

The short answer is: the price falls within the ranges of $6,000-$10,000 depending on the technique, surgeon costs, and gravity of the problem. The good news is that breast cancer patients don’t have to pay for it. That being said, prophylactic mastectomy surgeries do not go through with insurance companies most of the time.

Mind you that breast reconstruction surgery is Medisave claimable in most cases. That’s great news for people going through this as they are already having a lot on their plate. In areas where the surgery is not covered by insurance, the cost can be overwhelmingly reaching the staggering $70,000.

Here is a breakdown of the different procedures for breast cancer to make it more clear:

  • Partial mastectomy: $4,330-$6,580
  • Nipple-sparing mastectomy: $3,455-$7,141
  • Modified radical mastectomy without breast reconstruction: $6,036 – $8,195
  • Modified radical mastectomy with breast reconstruction: $22,720
  • Breast conservation surgery: $26,330
  • Breast reconstruction alone: $10,000-$70,000

What else is in the price of breast cancer surgery:

  • Average hospital inpatient charge: $4,000-6,000
  • Surgeon’s fees: $2,800-$3,500
  • Radiotherapy charge: $18,700 (does not apply in all cases)

Regardless of whether you have a partial or radical mastectomy, with some or the entire breast removed, you should do something to address the problem as soon as a breast cancer diagnosis has been made.

In many cases, the risk of breast cancer outweighs the risk of mastectomy. That is not to say the procedure is 100% safe. As every surgery, it is a pretty serious thing that you have to mentally prepare for.

How to reduce the risk of breast cancer

There is no way to entirely prevent breast cancer but there are things you can do to significantly lower your odds of developing the disease. Here are some simple changes to apply to your lifestyle:

  • Keep your weight in healthy ranges
  • Breastfeed
  • Stop smoking
  • Avoid alcohol or limit your intake
  • Stay physically active
  • Add more healthy foods to your diet and avoid processed foods, palm oil, white sugar, etc.
  • Avoid exposure to environmental pollution and radiation
  • Never miss your annual check-ups – detecting a problem early on can be a lifesaver
  • Try not to stay on hormone therapy for over 4-5 years
  • Minimise stress levels

Breast size does matter when it comes to this. Generally speaking, women with denser breasts are more likely to get cancer due to higher levels of oestrogen. Also, mammograms might not be able to detect it because of the amount of fat cells.

Again, taking care of your body will not deter breast cancer from happening but it will make it less possible for you to get it. Besides, it will decrease the risk of heart disease, diabetes, and stroke.