Mastectomy Options

A modified radical mastectomy (MRM) is a surgery that removes the entire breast—including the breast tissue, nipple, areola, and most of the breast skin—along with some lymph nodes under the arm. Unlike older radical mastectomy techniques, the chest wall muscles are left in place, which helps preserve strength and makes reconstruction possible.

This type of mastectomy is usually recommended when breast cancer has spread beyond the breast tissue into nearby lymph nodes.

How It Works

During a modified radical mastectomy:

• The surgeon removes all breast tissue, the nipple, and the areola.

• Most of the breast skin is also removed.

• The axillary lymph nodes (lymph nodes under the arm) are removed, either partially or fully, depending on cancer involvement.

• The chest wall muscles (pectoralis major and minor) are left intact, unlike in a “radical mastectomy.”

• Reconstruction with implants, flaps, or flat closure may be performed immediately or delayed until after treatment.

Who May Be a Candidate

A modified radical mastectomy may be recommended if:

• You have invasive breast cancer with spread to underarm lymph nodes.

• You have multiple tumors or widespread cancer in one breast.

• You are not a candidate for breast-conserving surgery (lumpectomy).

• Your doctor needs to evaluate and remove lymph nodes for staging and treatment planning.

Benefits of Modified Radical Mastectomy

• Effective cancer control: Removes both the breast and the lymph nodes most likely to carry cancer cells.

• Preserves chest muscles: Easier recovery and better function compared to older radical mastectomy methods.

• Supports reconstruction: Reconstruction is still possible since chest muscles are preserved.

• Clarifies treatment needs: Lymph node removal helps determine whether additional therapies (like chemotherapy or radiation) are necessary.

Things to Keep in Mind

• Appearance changes: The breast, nipple, and areola are removed, which can affect body image.

• Sensation loss: Most women lose feeling in the breast and chest wall area after surgery.

• Lymphedema risk: Removing lymph nodes increases the chance of arm swelling, heaviness, or discomfort.

• Scarring: A horizontal scar is usually present across the chest and sometimes under the arm.

• Recovery: Hospital stay is typically 1–3 days, with several weeks of healing before returning to full activities.

Emotional Considerations

Many women feel relief knowing the cancer and nearby lymph nodes have been removed, but adjusting to the physical and emotional changes of mastectomy can be challenging. Concerns about body image, femininity, and arm discomfort are common—and support is available through counseling, peer groups, and reconstruction or flat closure options.

A Personal Choice

Modified radical mastectomy is about removing cancer thoroughly while preserving your strength, function, and choices for the future. It is a proven and effective treatment for breast cancer that has spread beyond the breast itself. While it removes more than a simple mastectomy, it still preserves muscle and allows for future reconstruction.