A mastectomy is a surgery to remove one or both breasts, either partially or completely, usually to treat or prevent breast cancer. It can range from removing just breast tissue to more extensive procedures that include lymph nodes and underlying muscles. Mastectomies are considered when other treatments, like lumpectomy with radiation, are insufficient, or for high-risk people to prevent cancer.
Preparation for mastectomy surgery ensures a successful outcome and involves several important measures:
Medical Assessments
Patients undergo comprehensive evaluations, including blood tests, imaging studies such as mammograms and MRIs, and consultations to assess overall health and the specifics of breast cancer.
Physical Preparations
Patients may be advised to stop certain medications, avoid eating or drinking before surgery, and arrange for post-operative care and assistance at home.
Indications for Mastectomy
Mastectomy is recommended for several medical reasons, including:
Early-stage breast cancer: Recommended when patients prefer it over lumpectomy or when lumpectomy is not suitable.
Locally advanced breast cancer: Necessary when cancer has spread extensively within the breast or nearby structures.
After lumpectomy procedure: If breast cancer returns, a mastectomy may be needed to manage the disease.
Genetic predisposition: People with BRCA1 or BRCA2 gene mutations may choose a prophylactic mastectomy to significantly reduce breast cancer risk.
Radiation therapy difficulties: For patients who cannot undergo radiation therapy due to medical reasons or previous treatments, mastectomy may be preferred.
DR. TAN CHUAN CHIEN
Key Guiding Philosophies
Competency
Dr. Tan is a Fellowship-trained Breast & Endocrine Surgeon who is registered on the Specialist Register (General Surgery) in both Singapore and Australia. He completed his formal Breast Surgery training through the BreastSurgANZ Fellowship Programme. He was previously Head, Division of Breast & Endocrine Surgery, NTFGH where he was the pioneer breast surgeon there developing a comprehensive, evidence-based Breast Surgery service.
Care for the wider community
Dr. Tan is passionate about engaging the wider community with regards to breast cancer outcomes. He volunteers with the Singapore Cancer Society and served as the Chairman of the Breast Cancer Awareness Campaign Committee from 2018 to 2021. He continues to currently serve as a member of this committee. During his time in the public hospital, Dr. Tan was involved in research on breast cancer screening and care, where he succeeded in obtaining competitive grants and managing a research team, with the overall aim to improve breast cancer outcomes in Singapore.
Patient-centered care
Dr. Tan believes in the importance of the patient experience and the partnership between doctor and patients in healing sickness. He also believes no two individuals are the same. He believes in the philosophy of personalised tailor-made care plans for each of his patients to meet their individual expectations and needs.
Comprehensive Breast, Thyroid and General Surgery service
Dr. Tan aims to provide comprehensive, evidence-based care to all his patients, in a modern equipped clinic along the entire spectrum of the patient journey from diagnosis, through treatment/surgery and aftercare.
Types of Mastectomy
Mastectomies are grouped into different types based on how much tissue is removed and the extent of the surgery:
Simple or Total Mastectomy
This procedure involves the removal of the entire breast, including all breast tissue but no lymph nodes. It is commonly performed when the cancer is confined to one area of the breast.
Modified Radical Mastectomy
This includes the removal of the entire breast and the axillary lymph nodes under the adjacent arm. This type is often chosen if there are concerns about cancer spreading to the lymph nodes.
Radical Mastectomy
This extensive procedure involves the removal of the breast, all of the axillary lymph nodes, and the chest wall muscles under the breast. It is typically reserved for large tumours or extensive cancer spread.
Partial Mastectomy
Often used interchangeably with a lumpectomy, it is a less invasive surgery meant to conserve most of the breast tissue while removing as much of the cancer as possible. It may be an option when the cancer is small but requires more extensive removal than just the tumour and a small margin of surrounding tissue.
Preventive (Prophylactic) Mastectomy
Performed on people at high risk of breast cancer, such as those with a family history or genetic markers, this surgery removes one or both breasts to significantly reduce the risk of developing breast cancer.
As a supporter of personalised surgical care, I understand that no two patients are the same. I believe in tailoring management for each patient to meet each individual’s needs and expectations. A patient’s journey can be difficult and frustrating at times, so I strive to make this experience as pleasant and seamless as possible.
Dr. Tan Chuan Chien
For Singaporeans, Singapore Permanent Residents and foreigners
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Frequently Asked Questions
How long does it take to recover from a mastectomy?
Recovery times can vary, but most patients can resume normal activities within 4 to 6 weeks after surgery. Complete healing and adjustment to any changes may take several months.
Will I need chemotherapy or radiation after a mastectomy?
Whether chemotherapy or radiation is necessary after a mastectomy depends on the stage and type of cancer, as well as the results of the surgery.
How will a mastectomy affect my ability to exercise?
After a mastectomy, patients are generally encouraged to gradually return to exercise, focusing on rebuilding strength and flexibility without straining the surgical site.
Dr. Tan Chuan Chien
Consultant General Surgeon Breast & Thyroid Surgery
Bachelor of Medicine & Bachelor of Surgery (MBBS)- The University of Adelaide, Australia
Fellow of the Royal Australasian College of Surgeons (FRACS)
Full Registration, Singapore Medical Council (SMC) and Specialist Accreditation Board, Singapore (General Surgery)
Full General & Specialist Registration (General Surgery), Australian Health Practitioner Regulation Agency (AHPRA)
Completed Breast Surgery training through the BreastSurgANZ Fellowship programme
Fellow of the Academy of Medicine, Singapore (FAMS)
Dr. Tan Chuan Chien is a Fellowship-trained Breast and Endocrine Surgeon practicing as a Consultant General Surgeon at Gleneagles Hospital, Singapore. He also sees patients at Mount Elizabeth Novena Specialist Centre and Parkway East Medical Centre. Dr. Tan is a registered Specialist Surgeon (General Surgery) in both Singapore and Australia.
We are equipped with modern and updated equipment, and a team that will take care of all your needs.
Accredited Specialist
Dr. Tan is a Fellow of the Royal Australasian College of Surgeons (FRACS). He is also accredited to practice as a Specialist in both Singapore and Australia.
Focused After Care
Dr. Tan firmly believes that transdisciplinary care is the key to every patient’s recovery journey.
Video-consultation for overseas patients
Dr Tan is available via video-consultations for patients who are not in Singapore.
The Mastectomy Procedure
The mastectomy procedure typically follows these steps and varies slightly depending on the type of mastectomy performed:
Anaesthesia
Patients receive general anaesthesia to ensure they are unconscious and pain-free during the surgery.
Incision
An incision is made on the breast. The location and size of the incision depend on the type of mastectomy:
Simple (Total) Mastectomy: The incision usually encircles the nipple area.
Modified Radical Mastectomy: The incision may be larger to allow for the removal of additional tissue and lymph nodes.
Radical Mastectomy: The incision is extensive to accommodate the removal of muscle tissue along with the breast and lymph nodes.
Partial Mastectomy: The incision is made over the tumour and a portion of surrounding tissue, often used interchangeably with a lumpectomy.
Preventive (Prophylactic) Mastectomy: The incision varies based on whether one or both breasts are being removed.
Tissue Removal
Tissue removal involves excising the breast tissue and potentially surrounding structures, depending on the extent of the cancer and the type of mastectomy:
Simple (Total) Mastectomy: The entire breast tissue is removed.
Modified Radical Mastectomy: The entire breast tissue and axillary lymph nodes are removed.
Radical Mastectomy: The entire breast tissue, axillary lymph nodes, and chest wall muscles are removed.
Partial Mastectomy: The tumour and a portion of surrounding tissue are removed.
Preventive (Prophylactic) Mastectomy: The breast tissue is removed to reduce cancer risk.
Reconstruction (If Planned)
If desired and appropriate, immediate reconstruction can be performed following the mastectomy. This involves the use of implants or autologous tissue to reconstruct the breast.
Wound Closure
The incisions are closed with sutures, and drains are often placed to prevent fluid accumulation in the breast or underarm area. These drains help reduce the risk of complications such as seromas or hematomas.
Potential Risks and Complications
Mastectomy, like any surgical procedure, can lead to complications. Some factors include:
Infection: Infection may manifest as redness, swelling, warmth, or discharge at the surgical site, and is typically treated with antibiotics and close monitoring to prevent further complications.
Bleeding and Hematoma Formation: Excessive swelling or bruising and pain at the surgical site may indicate bleeding or hematoma formation. Small hematomas may resolve, but larger ones might require surgical drainage.
Lymphedema: Following lymph node removal, patients might experience swelling in the arm on the side of the surgery, known as lymphedema. Managing this involves physical therapy, compression garments, and careful limb monitoring.
Seroma: Seroma, or fluid collection under the skin where the tissue was removed, may need to be drained with a needle and syringe if it causes discomfort or persists.
Pain and Numbness: Chronic pain or numbness in the chest wall, armpit, or arm are common and can be managed with medications, physical therapy, and sometimes, nerve treatments.
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