When surgically treating people for cancer, a doctor’s primary goal is to remove as much of the cancer as possible.
While nonsurgical options are available, they may prove to be less effective. For that reason, if you have breast cancer, doctors may recommend a modified radical mastectomy (MRM).
An MRM is a procedure that involves removal of the entire breast — including the skin, breast tissue, areola, and nipple — along with most of the axillary (armpit) lymph nodes.
However, most of the chest muscles are left intact.
There are actually two types of MRM:
- Patey’s operation (Patey modified radical mastectomy). In this type, the pectoralis major muscle is maintained, but the pectoralis minor muscle isn’t.
- Auchincloss’ operation (Auchincloss modified radical mastectomy). In this type, both the pectoralis major and pectoralis minor are maintained.
The MRM is a standard option for treating breast cancer. The procedure can be used to address both female and male breast cancer.
Who usually gets a modified radical mastectomy?
An MRM may be recommended to people whose breast cancer has spread to the axillary lymph nodes. MRM is also an option for treating any breast cancer where there may be a reason to remove the axillary lymph nodes.
Similar to the MRM, a radical mastectomy involves removing the entire breast — the skin, breast tissue, areola, and nipple. However, this procedure also involves removing the chest muscles.
The radical mastectomy is the most invasive surgical treatment for breast cancer. It’s only considered if a doctor has found a tumor that’s spread into the chest muscles.
Once a more common treatment for breast cancer, the radical mastectomy is now rarely performed. People who receive the radical mastectomy and people who receive the MRM have similar cancer survival rates. The MRM has proven to be a less invasive procedure with equally effective results.
A simple mastectomy is also known as a total mastectomy. In this procedure, the entire breast is removed. In certain cases, some axillary lymph nodes may be removed too.
The difference between an MRM and a simple mastectomy is that more axillary lymph nodes are removed during an MRM.
Other surgical optionsThere are many surgical options for breast cancer aside from the modified radical mastectomy. They include the:
- radical mastectomy
- simple mastectomy, which is also known as total mastectomy
- partial mastectomy
- nipple-sparing mastectomy, which is also known as subcutaneous mastectomy
- skin-sparing mastectomy
- lumpectomy, which is also known as breast lump removal or breast conservation therapy
The overall goal of an MRM is to remove all or most of the cancer present while preserving as much of the healthy skin tissue as possible. This makes it possible to perform an effective breast reconstruction after you’ve healed properly.
Speak with your doctor to learn which specific steps you should take before your surgery. Preparation typically involves stopping certain medications or supplements. You may also be asked to use a special antiseptic soap.
For an MRM, you’ll be placed under general anesthesia.
Your doctor will then mark your chest to prepare for incisions. Making one incision across your chest, your doctor will carefully pull your skin back far enough to remove your breast tissue. They’ll also remove most of the lymph nodes under your arm.
The entire procedure commonly takes between 2 to 3 hours.
Once your lymph nodes are removed, your doctor will examine them to determine whether cancer has spread to them or through them to other areas of your body.
Your doctor will also place thin plastic tubes in your breast area to drain any excess fluid. They may remain in your chest for up to 1 to 2 weeks.
As with any surgical procedure, MRM can cause a number of complications. Risks of this procedure include:
- pain or tenderness
- bleeding
- swelling in your arm or incision site
- redness and warmth at the incision site, suggestive of infection
- limited arm movement
- numbness
- seroma, or fluid buildup beneath the wound site
- hematoma, or blood buildup in the wound
- scar tissue
Recovery times differ from one person to the next. Typically, people remain in the hospital for 1 or 2 days. In some cases, your doctor may recommend radiation therapy or chemotherapy following your mastectomy procedure.
Once you’re at home, it’s important to keep your surgical area clean and dry. You’ll be given specific instructions on how to care for your wound site and how to properly bathe.
Pain is normal, but the amount of discomfort you experience may vary. Your doctor may suggest pain relievers. If so, only take what’s prescribed. Some pain medications can cause complications and slow your healing process.
Constipation is a common aftereffect of surgery. You may need to make temporary changes to ease the symptoms, such as modifying your diet or taking stool softeners.
Lymph node removal can cause your arm to feel stiff and sore. Your doctor may recommend certain exercises or physical therapy to increase movement and prevent swelling. Perform these exercises slowly and regularly to prevent injury and complications.
If you begin to experience more discomfort or if you notice you’re healing at a slower pace, schedule an appointment with your doctor.
An MRM is a safe and effective procedure for treating breast cancer.
However, there are many surgical options available. While an MRM is common, your doctor will recommend the best option for your situation.
If you have concerns about any procedure, talk with your doctor. They can help guide you toward the best decision for your health.