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Mastectomy and breast reconstruction - 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 some questions you may want to ask your health care provider about mastectomy and breast reconstruction.

Alternate Names

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

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?
  • 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 provider before my surgery?

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

  • What are the different choices? 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?

Updated: 1/24/2013

Debra G. Wechter, MD, FACS, General Surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.


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