Mammograms and the Several Types of Mastectomies

After a mastectomy, there has to be an upside. Of course, removing a deadly cancer can be one of them. So can saying, “I don’t have to go through an annual mammogram anymore!” That’s mostly right. Prevention is still the frontline of the battle against breast cancer, and early detection falls right behind that. So let’s talk about mastectomies and mammograms.

Ultimately, what it comes down to is this: if you have any breast tissue remaining, you still want to be vigilant about mammography – and that’s a determination you make very carefully with your physician.

There are several types of mastectomies:

• Simple/total mastectomy is used to remove nipple and breast tissue but not lymph nodes or chest muscle. It is typically used in preventive mastectomies (for BRCA gene carriers for instance), or for breast cancers that have no spread into the lymph nodes.

• A radical mastectomy is on the opposite end of the mastectomy spectrum: it does reach into both the chest wall as well as all the lymph nodes extending up under the arm, in addition to removing the breast. This is called “radical” for a reason – it is uncommon these days.

• In the middle is the modified radical mastectomy, which removes everything that a radical mastectomy does, saving the chest wall.

• The mastectomy most sparing of breast tissue is called the subcutaneous, or “skin-sparing” mastectomy. While breast tissue is removed, the nipple and the tissue just under the skin are left intact.

With the exception of the “skin-sparing” mastectomy, all others no longer require mammograms, as there is no breast tissue to x-ray. Whether or not other forms of screening are used in the area around where the breast had been requires a conversation with a physician. However, if only one breast was removed, the remaining breast is high-risk and requires vigilance in the form of self-exams, mammograms, and in case of dense breasts, possibly breast ultrasounds.

Whatever situation you find yourself in, know that there are guidelines but rules that can change with technology. It’s important to insist upon being treated as an individual by your physician, and that your particular needs are being addressed when it comes to post-mastectomy mammograms and breast health care. Make sure you are aware of changes that can be seen or felt in breast tissue and that you keep your healthcare provider aware of them too. Mammograms may no longer be the direct course of action, but don’t hesitate to take action when needed.

Originally published 5/29/13 on mammographykc.com.