A Modified Radical Mastectomy is a more aggressive procedure that entails removal of the breast and most of the lymph nodes under the arm. It is indicated when cancer has spread to the lymph nodes at the time of surgery.
This procedure removes as much breast tissue as possible. Included are the nipple, some of the overlying skin, as well as the lymph nodes. The lining over the chest muscles must also be removed and, rarely, a portion of the chest-wall muscles themselves.
Breast reconstruction can begin at the time of the surgery if the patient wishes. Drains are placed; removal generally occurs 7-14 days later during an office visit. A hospital stay of one to two days is required, and pain medicines are usually needed for several days after discharge.
“Who usually gets a modified radical mastectomy rather than one of the more breast-conserving options?”
Most people with invasive breast cancer who decide to have mastectomies will receive modified radical mastectomies so that the lymph nodes can be examined. Examining the lymph nodes helps in determining whether cancer cells may have spread beyond the breast.
“What are some of the considerations involved in the decision to have a modified radical mastectomy?”
If the tumor is larger than five centimeters, a mastectomy (rather than a lumpectomy) will probably be required. The more radical procedure would also be indicated if several attempts have been made to remove the tumor with lumpectomy but cancer is still present. In addition, mastectomy may be preferable if the breast is small and a lumpectomy would leave very little breast tissue intact.