Dr. Wasif describes and illustrates the mastectomy procedures available for women who are diagnosed with breast cancer.
Let me walk you through the different types – about 30 years ago, really there was just only one operation for breast cancer and that’s called a radical mastectomy, in which not only does the breast come off, but also part of your chest wall muscles. It’s a very disfiguring surgery and it has many long-term sequelae in terms of weakness.
We evolved from that to what we call a total mastectomy in which you only take the breast and not the muscles, and then we have evolved even further. The most common operation for breast cancer now-a-days is something called a segmental mastectomy where we only take the part of your breast which actually has the tumor and you keep the rest of your breast.
The skin-sparing mastectomy and now the newest innovation, which is the nipple and skin-sparing mastectomy, are improvements on the traditional total mastectomy in which case we take your breast, but we leave the skin above it and now we even leave the nipple so that ultimately when you have the reconstruction, it’s a much more natural looking breast.
On this side, on my right here is a diagram that shows what a traditional mastectomy incision would be like. It’s kind of like an ellipse where we go around the entire areola as well as the nipple and that would be, as you can see, the incision goes pretty much from one side of the breast to the other and eventually it will be a straight line here in the middle.
Now, in a nipple-sparing mastectomy, which is here closer to me on the left side, now you can, the dotted line shows you how the incision is different. So you have about an incision going on only one side of the breast and it goes around sort of one quadrant of the entire areola. So at the end of this, not only do you have your nipple and areola left, but you can see that there’s no cut on the other side of the breast.
So the only incision you have really is a line here because eventually this part, the curved part, melds into the border of the areola and you can’t even see it. So there you can see the main difference between the two is the size on the incision and obviously the fact that the nipple and the areola stays on the breast.
About Dr. Nabil Wasif, M.D.:
Dr. Nabil Wasif, M.D., is a general surgeon at Mayo Clinic in Arizona, certified by the American Board of Surgery. He graduated from Aga Khan University Medical College in Pakistan and completed his residency in general surgeon at New York Presbyterian Hospital-Cornell in New York. His interests include surgical oncology, general surgery, GI oncology, breast cancer, melanoma, and sarcomas.