Medical Oncologist
CION Cancer Clinics
Mastectomy: what the operation involves | CION Cancer Clinics
In a mastectomy you are fully asleep while the surgeon removes the breast tissue through one cut across the chest, checks or removes some lymph nodes in the armpit, and closes the skin, usually leaving a drain. Most people go home within a night or two. This page walks through the day, what is removed, the words on your forms, and what it cannot tell you. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- What happens during a mastectomy?
- What happens from admission to the ward, step by step?
- What exactly does the surgeon remove?
- Which words will you see on the forms, and what do they mean?
- How is a mastectomy different from removing only the lump?
- What do families believe about mastectomy that is not true?
- What can this page not tell you?
- Common questions about the mastectomy operation
The short answer
What happens during a mastectomy?
A mastectomy is an operation to remove the breast. You are fully asleep under a general anaesthetic, the surgeon removes the breast tissue through one cut across the chest, checks or removes some lymph nodes in the armpit, and closes the skin with stitches, usually leaving a thin tube called a drain.
How long it takes and how long you stay
The operation itself usually takes between one and three hours. It takes longer if a new breast shape is made at the same time. Most people go home after one or two nights, often with the drain still in and a nurse's instructions on how to look after it.
What the operation does not touch
In a standard mastectomy the chest muscle stays where it is. Your ribs and lungs are not opened. The shoulder joint is not operated on, although the arm on that side will feel stiff for a few weeks because of the wound and the armpit work.
Who decides it is the right operation
That decision belongs to your treating team, not to a web page. They weigh the size and position of the cancer, the size of the breast, whether radiotherapy is planned, your general health and what you want. For some people removing only the lump is equally safe, and a mastectomy is not needed.
On the day
What happens from admission to the ward, step by step?
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Admission and fasting
You come in on the morning of surgery or the evening before. You will be told when to stop eating and drinking. Bring every report, your medicines in their boxes and one family member who can stay.
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Consent and marking
The surgeon goes through the consent form with you and draws on the skin with a marker pen to show the side and the line of the cut. Ask anything you are unsure of now. It is not too late.
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The anaesthetic
In the operation theatre a thin plastic tube is put into a vein in your hand. The anaesthetist gives the medicine that puts you to sleep. You feel nothing and remember nothing of the operation.
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The operation
The breast tissue is lifted off the chest muscle and removed in one piece. The lymph nodes are checked or removed through the same cut or a small second one. A drain is placed and the skin is stitched.
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The recovery room
You wake up with a firm dressing on the chest and the drain bottle beside you. Feeling sleepy, cold or a little sick is common for the first hour or two.
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Back on the ward
Most people sit up, drink and walk to the toilet the same evening. Pain is controlled with tablets or a drip. Family can usually see you once you are settled.
Not sure whether this applies to you?
Ask an oncologistWhat is taken out
What exactly does the surgeon remove?
The breast is only part of it. What happens in the armpit often matters as much for your recovery.
The breast tissue
All of the gland and fat that make up the breast, from the collarbone down to the fold under the breast and across to the armpit. It is sent to the laboratory in one piece.
Skin and nipple
In most mastectomies the nipple and some skin go with the breast, leaving a flat chest and a straight or slightly curved scar. Some operations keep more skin, or the nipple as well.
Whether that is possible depends on where the cancer sits.A few lymph nodes
If the armpit looked normal on scans, the surgeon usually removes only the first few lymph nodes (the small glands that drain the breast). This is called a sentinel node biopsy.
More lymph nodes
If cancer is already known to be in the armpit, most of the nodes there may be removed. This is called axillary clearance.
It tends to mean
- A drain for longer
- More arm stiffness at first
- A higher chance of arm swelling later
On your consent form
Which words will you see on the forms, and what do they mean?
- Total or simple mastectomy
- The whole breast is removed, with the nipple, but the armpit is left alone apart from a sentinel node check.
- Modified radical mastectomy
- The whole breast plus most of the lymph nodes in the armpit. The chest muscle is kept.
- Drain
- A soft tube coming out of the skin into a small bottle. It collects the fluid the wound makes while it heals.
- Seroma
- A pocket of clear fluid under the scar after the drain comes out. It is common and is often drained with a needle in clinic.
- Histopathology
- The laboratory report on what was removed. It confirms the type and size of the cancer and how many nodes were affected.
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Side by side
How is a mastectomy different from removing only the lump?
Mastectomy
Breast-conserving surgery
The whole breast is removed
Only the lump and a rim of normal tissue are removed
Radiotherapy afterwards only in some situations
Radiotherapy to the breast is almost always part of the plan
Often chosen for a large cancer, or cancer in more than one area
Often chosen for a smaller cancer in one area of a larger breast
A flat chest unless a new breast shape is made
The breast stays, sometimes a little smaller or a different shape
Commonly believed
What do families believe about mastectomy that is not true?
"Removing the whole breast is always the safer choice."
Not for everyone. For many cancers that can be removed with a lump operation followed by radiotherapy, large studies found the two approaches work equally well. A bigger operation is not automatically a safer one.
"Opening the breast with surgery makes the cancer spread."
Surgery does not cause cancer to spread. This belief makes families delay, and delay is what allows a cancer to grow. The operation removes the cancer that is there.
"After a mastectomy she will never use that arm properly again."
Most people get back their normal arm movement with gentle daily exercises started soon after surgery. Stiffness is expected at first.
"Once the breast is gone, no other treatment is needed."
Often it is. Depending on the laboratory report, you may still be offered chemotherapy, hormone tablets, targeted drugs or radiotherapy. The surgery is one part of the plan.
Being straight with you
What can this page not tell you?
It cannot tell you whether a mastectomy is right for you or for your mother. It cannot tell you what your scar will look like or how your own recovery will go. Those depend on your scans, your biopsy report and a surgeon examining you.
Questions worth taking to the appointment
Ask why a mastectomy is being recommended rather than a lump operation. Ask what will be done in the armpit, and why. Ask whether a new breast shape can be made now or later, and whether radiotherapy is likely afterwards, because that changes the reconstruction choice. Ask who to call at night.
If the wound becomes hot, red and more painful, or you develop a fever at home, call your surgical team the same day.Questions we are asked
Common questions about the mastectomy operation
Will she be awake during the operation?
No. A mastectomy is done under a general anaesthetic, so you are fully asleep and feel nothing. The anaesthetist stays with you the whole time, watching your breathing, heart and blood pressure. You wake up in the recovery room once the dressing is on and the drain is in place.
How much pain is there afterwards?
Most people describe soreness and tightness across the chest and armpit rather than severe pain. Regular painkillers control it for most people, and they are usually needed for a week or two. Numbness on the inner arm is common. Tell the nurses if the pain stops you moving or breathing deeply.
Does she need blood before or during surgery?
Rarely. A mastectomy usually involves only a small amount of blood loss. Your blood group is checked beforehand as a routine precaution. If your haemoglobin is low before surgery, the team may want to correct that first, so bring any recent blood reports with you.
Should I stop my blood thinner or diabetes tablets?
Do not stop, start or change any medicine on your own. Tell the surgeon and the anaesthetist about everything you take, including aspirin, clopidogrel, insulin and herbal remedies. They will tell you exactly what to do with each one and when, because the timing differs from person to person.
When will we know if the cancer was fully removed?
Not on the day. The breast and nodes go to the laboratory, and the full histopathology report usually takes one to two weeks. The surgeon explains it at your wound check visit, along with whether more treatment such as chemotherapy or radiotherapy is being advised.
When can she go home, and how does the drain work?
Many people go home after one or two nights. The drain may go home with you in a small bag. A nurse shows you how to empty it and write down the amount each day. It comes out in clinic once the fluid slows down.
Can a new breast be made during the same operation?
Sometimes. This is called immediate reconstruction, using an implant or tissue from your own body. It suits some people and not others, particularly if radiotherapy is planned afterwards. Reconstruction can also be done months or years later. Ask the surgeon what is possible in your situation.
Is the surgery covered by Aarogyasri or insurance?
Breast cancer surgery is usually covered under Aarogyasri, CGHS, ECHS, EHS and most cashless insurance policies when it is part of a cancer treatment plan. What each scheme pays for, such as reconstruction, varies. Call the helpline with your card details before admission so the cover can be checked.
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Sources
- NHS — Mastectomy
- American Cancer Society — Mastectomy
- Cancer Research UK — Breast cancer
- National Cancer Institute — Surgery choices for women with DCIS or breast cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Types of Mastectomy ExplainedSimple, modified radical, skin-sparing and nipple-sparing comparedThe Drain After MastectomyHow to look after the drain at homeArm Exercises After MastectomyGetting the shoulder moving again safelyThe Day of the OperationWhat to bring and what to expect on the morningBreast cancer guideThe full CION breast cancer section
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Been told you need a mastectomy?
Send us your biopsy and scan reports, or call the helpline. A surgical oncologist will go through what is being proposed and what to ask. One helpline serves every CION centre.