Through the years, experts have disagreed on the best mastectomy options, leading to widespread myths about the procedure. Here are some of the most common mastectomy myths and the truth behind them.
1. Myth: You Must Have a Mastectomy If You Have Breast Cancer
Because doctors now perform lumpectomies alongside other modern treatments, lumpectomy and mastectomy offer equal rates of survival and recurrence (when breast cancer comes back), says Dana Henkel, MD, a breast cancer and oncoplastic surgeon at the SSM Health Dean Medical Group in Madison, Wisconsin. “The bottom line is that bigger surgery (mastectomy) is not usually better,” says Dr. Henkel.
2. Myth: A Mastectomy Will Remove All the Cancer
Experts used to think that cancer stayed in the breast for a long time before spreading, and early research showed a very low rate of breast cancer returning after a mastectomy. These ideas may have led to a common belief that this surgery removes all cancer.
“While mastectomy significantly reduces the risk of recurrence in the breast, it does not eliminate it entirely,” says Monique Gary, DO, a breast surgical oncologist at St. Luke’s Cancer Care Associates Surgical Oncology in Sellersville, Pennsylvania.
Even though surgical techniques have improved, no surgeon can remove every single cell that may turn into cancer in the future. “A small risk remains, usually under the skin or along the chest wall,” says Dr. Gary, who recommends follow-up care and regular clinical exams after a mastectomy.
3. Myth: Quality of Life Will Be Permanently Diminished After a Mastectomy
Removal of breast tissue may feel frightening, and many women worry their quality of life will never recover after a mastectomy. But Gary has witnessed many women live full lives after the procedure.
Mastectomies do come with some risks, like pain, swelling, or numbness, but complications are rare. Beyond the physical effects, breast removal can leave you with feelings of grief, fear, or anger, and some women report having a negative body image after a mastectomy.
Whatever emotions you feel are normal and even expected, but you don’t have to go through them alone. Breast cancer support groups can offer community and helpful advice. It may take time to adjust to your new body, but Gary finds her patients recover very well after surgery.
“I see patients return to full, active lives after mastectomy — they paddleboard, engage in rigorous exercise, and enjoy intimacy,” says Gary, adding that a good quality of life after mastectomy is absolutely possible. “When it’s the right surgery for the right patient, mastectomy can be both physically and emotionally empowering.”
4. Myth: Reconstruction or Implant Placement Must Happen During or Immediately After Mastectomy
Because the medical results are so similar (though cosmetic results are better with immediate reconstruction), you can base your reconstruction timing choice on personal preference. If you’re not sure about reconstruction or when to have it, you can always wait or decide to skip the procedure.
“There are a growing number of patients who prefer a flat closure without reconstruction,” says Cletus A. Arciero, MD, a surgical oncologist, professor of surgery, and the program director of the Breast Surgical Oncology Fellowship at Winship Cancer Institute of Emory University in Atlanta. “Some want to avoid additional surgery, some feel like their breasts do not define their womanhood, and some feel like a sense of freedom can be achieved by going flat.”
The decision is yours, and your breast surgeon can discuss all your options in depth before you make a final choice.
5. Myth: Breast Reconstruction Is ‘Just Cosmetic’
Some hesitate to ask for a breast reconstruction because they feel it’s only cosmetic and not a vital part of treatment. In the early days of mastectomy procedures, experts worried that reconstruction would lower survival, hide returning cancer, or even spread cancer cells during the operation.
More recent research has found no increase in breast cancer return after reconstruction. Breast reconstruction after a mastectomy is not considered cosmetic, and U.S. federal law makes every insurance plan cover it after a medically necessary masectomy. You may choose breast reconstruction to feel better about your body after cancer, to avoid using prosthetics in your bra, or to help clothes fit better.
6. Myth: If I Get a Mastectomy I Won’t Need Chemotherapy
“Two types of breast cancer that are always treated with chemotherapy are triple-negative breast cancer and HER2-positive breast cancer,” says Henkel. For people with hormone-positive (HR+) breast cancer, providers use genetic testing on the tumor to analyze and predict the cancer’s behavior, which tells them which treatments to use, says Henkel.
Along with mastectomy, you may need chemotherapy, hormone-blocking therapy, or even radiation in some situations, says Dr. Arciero. “A multidisciplinary team consisting of a surgeon, a medical oncologist, and a radiation oncologist will help guide a patient to the best approach for their cancer.”
7. Myth: You Can’t Have Reconstruction if You Need Radiation
This myth exists because it can be true in some cases. Radiation treatment uses strong X-rays or similar technology to kill cancer cells, and it can cause side effects in the breast tissue like color changes, skin thickening, and sores. Breast reconstruction after mastectomy can have more complications if you’ve had radiation therapy, but experts don’t always agree on the best solution.
If you have radiation side effects, your provider may recommend a different type of reconstruction than if you had no side effects. To learn your options for reconstruction after radiation, ask your doctor, who will suggest the best and safest choice.
The Takeaway
- Early practices around mastectomy for breast cancer have fueled many myths about this surgical treatment option.
- Common mastectomy myths suggest you must always have a complete mastectomy, you won’t need chemo if you’ve had a mastectomy, and that breast reconstruction is only cosmetic.
- Your choice of mastectomy or breast reconstruction is a personal one, and your doctor can help you create a treatment plan that keeps you safe and helps you feel good about your body.
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