The type of incision into the skin depends on the size of the tumour, the type of tumour and whether or not breast reconstruction is going to be carried out immediately.
The breast tissue is peeled from the skin. The skin and underlying fat are preserved. The breast is then removed whole, with the covering of the muscle underneath. If a modified radical mastectomy is done then the lymph nodes are removed through the same incision.
What happens in the axilla (armpit)?
The lymph nodes in the axilla will nearly always have to be removed if they are felt to be enlarged when the woman is first examined. This is carried out using a technique called an axillary dissection.
What is an axillary dissection?
It is removal of some or all of the lymph nodes in the axilla:
The incision may be as part of the mastectomy incision or may be through a separate incision. It may be done at the same time as a wide local excision.
If there are no enlarged lymph nodes on examination then there are different approaches:
- The lymph nodes may be left
- A sentinel lymph node biopsy may be performed
- A limited operation may be performed in which some of the lymph nodes are removed