A mastectomy is surgery to remove all or part of the breast, most often carried out as part of breast cancer treatment or to lower a high risk of developing it. Being referred for this kind of surgery can bring up a lot of emotions, and that is completely understandable.
This article is general information only and cannot replace advice from the doctors who know your situation. If you are ever experiencing a medical emergency, please call 000 or go to your nearest emergency department straight away.
Why a Mastectomy May Be Recommended
A mastectomy may be recommended for a number of reasons, and only your specialist can explain what applies to you. It is sometimes suggested when a tumour is large in relation to the breast, when cancer is found in more than one area, or when someone carries a genetic change linked to a higher lifetime risk, as explained on healthdirect’s breast cancer information page.
Your GP is usually the first point of contact, and a surgical referral to a specialist breast surgeon is needed both for treatment and for any Medicare rebate on specialist visits. Whether a mastectomy or breast-conserving surgery suits you best is something to discuss openly with your treating team.
Types of Mastectomy
There are several types of mastectomy, and your surgeon will explain which approach fits your circumstances. A total mastectomy removes all of the breast tissue, while a skin-sparing or nipple-sparing mastectomy keeps more of the skin, or the nipple, in place, which can support reconstruction later on.
Some people also have surgery to check or remove lymph nodes under the arm during the same operation. These are general descriptions only, and the right choice depends on factors like tumour size, location and your own preferences, best worked through directly with your surgical team.
Preparing for Your Mastectomy
Once surgery is planned, most people attend a pre-admission clinic, where nurses and other health professionals check your general health, review your medications and answer practical questions about the day itself.
You will also be asked to give informed consent, meaning your surgeon explains the procedure, benefits, risks and alternatives before you agree to go ahead. It is worth writing down questions in advance, since appointments can feel rushed when emotions are running high.
Some questions people find helpful to ask their surgical team include:
- What type of mastectomy is being recommended, and why
- Whether lymph nodes will be checked or removed at the same time
- What the expected hospital stay and early recovery will look like
- Whether breast reconstruction is possible now, later, or not at all
- What the likely costs are, including any out-of-pocket gap
The Day of Surgery
A mastectomy is typically carried out under general anaesthesia, meaning you are fully asleep and will not feel the procedure. An anaesthetist will talk you through what to expect and answer any questions beforehand.
Depending on the extent of surgery, some people go home the same day, while others stay in hospital for a few nights. Whether you are in a public or private hospital, the team will explain what to expect when you wake, including any drains or dressings. It can help to have a family member or friend on hand for support once you are settled back in your room.
Recovery After a Mastectomy
Recovery timelines vary from person to person, but most people need several weeks before returning to normal activities, and longer before lifting or exercising fully. Gentle movement, guided by your surgical team or a physiotherapist, helps ease stiffness in the arm and shoulder.
It is normal to feel tired and to need extra rest in the first few weeks, and any pain relief or wound care advice should come directly from your surgical team rather than general guides.
Allied health professionals, including physiotherapists, occupational therapists and psychologists, often support post-operative recovery. Follow-up appointments let your surgeon check on healing and discuss any further treatment.
Breast Reconstruction: A Separate Consideration
Some people choose breast reconstruction, either during the same operation as their mastectomy or at a later date, while others decide not to reconstruct at all. There is no single right answer, and it is a personal decision made with your surgical team.
Reconstruction options and timing depend on individual factors, including any further cancer treatment planned. Breast Cancer Network Australia has plain-language resources on the different pathways available, which can be a useful starting point before your appointment.
Emotional Support and the Cost of Surgery
A mastectomy can affect body image, relationships and mental health, alongside the physical recovery. Many people find it helpful to talk with a breast care nurse, counsellor or psychologist, or to connect with peer support groups of others who have been through something similar.
Costs vary depending on whether you are treated in the public or private system. Public hospital care is accessed through Medicare, though elective surgery may involve a waitlist, while private health insurance can offer more choice of surgeon and timing, subject to any relevant waiting periods and informed financial consent from your provider.
Conclusion
Facing a mastectomy is a significant experience, physically and emotionally, and there is no single right way to feel about it. Understanding the general pathway, from referral and preparation through to recovery and reconstruction options, can make the road ahead feel a little less daunting.
If you or someone you care about is considering this surgery, start by talking to your GP, breast surgeon or breast care nurse about your individual circumstances. You can also use surgery.com.au to find accredited surgeons across major Australian cities and take the next step at your own pace.
FAQs
1. How do I know if I need a mastectomy?
This is a decision made together with your breast surgeon or specialist team, usually after tests such as imaging or biopsy results. It depends on factors like the size and location of any concerning tissue, family history and personal preference. Your GP can arrange the referrals needed to have this conversation properly.
2. How long does recovery from a mastectomy take?
Recovery differs for everyone, but most people need several weeks before feeling back to normal daily activities. Full recovery, including regaining arm movement and strength, can take longer. Your surgical team will give you guidance based on your specific procedure and progress.
3. Will I need chemotherapy or radiotherapy as well as a mastectomy?
Some people need additional treatment after surgery, while others do not, and this depends entirely on individual test results and the type of cancer involved. Only your oncologist or treating specialist can advise on this for your situation. It is a good topic to raise early with your treating team.
4. Can I have breast reconstruction after a mastectomy?
Reconstruction is often possible, either during the same operation or at a later stage, though suitability depends on individual circumstances and any further treatment planned. Some people choose not to have reconstruction at all, which is equally valid. This is worth discussing in detail with your surgeon.
5. Does Medicare or private health insurance cover a mastectomy?
Medicare generally covers mastectomy surgery in the public hospital system, though elective surgery can involve a waitlist. Private health insurance may offer more choice over timing and surgeon, subject to your policy’s waiting periods and any out-of-pocket costs outlined in your informed financial consent. It is worth checking the details of your own policy with your insurer.