By continuing to use our site, you consent to the processing of cookies, user data (location information, type and version of the OS, the type and version of the browser, the type of device and the resolution of its screen, the source of where the user came from, from which site or for what advertisement, language OS and Browser, which pages are opened and to which buttons the user presses, ip-address) for the purpose of site functioning, retargeting and statistical surveys and reviews. If you do not want your data to be processed, please leave the site.

The Voice of People With Breast Cancer

helping you understand your surgical options

SurgeryGuide

Mastectomy

A mastectomy is the surgical removal of the entire breast. It may be recommended as part of breast cancer treatment or used to lower the risk of cancer for people with a high genetic risk.

Types of Mastectomies

Different types of mastectomies are available depending on your diagnosis, treatment plan, and personal preferences.

Total (Simple) Mastectomy

Removes the entire breast, including the nipple and areola. Lymph nodes may be removed at the same time

May be recommended if you:

Modified Radical Mastectomy

Removes the entire breast and some or all of the lymph nodes under the arm (axillary lymph node dissection)

May be recommended if you:

  • Cancer has spread to the nearby lymph nodes
  • You have inflammatory breast cancer
Skin-Sparing Mastectomy (SSM)

Removes breast tissue, nipple, and often the areola, but keeps most of the natural breast skin

May be recommended if you:

  • Commonly done when immediate reconstruction is planned
  • keeping the skin can help create a more natural-looking reconstruction
  • May not be recommended if:

  • Cancer involves or is close to the skin
  • You have been diagnosed with inflammatory breast cancer

If needed, lymph node removal is typically done during the same surgery.

Nipple-Sparing Mastectomy (NSM)

Removes breast tissue while preserving the nipple, areola, and most of the breast skin. Usually combined with immediate reconstruction

May be recommended if you:

  • Have early-stage breast cancer best treated with a mastectomy
  • Have no cancer near or involving the nipple

Keeping the nipple may help emotional well-being and give more natural looking results. However, NSM requires careful planning and surgical skill to ensure proper blood supply to the nipple.

NSM is not available in all regions and may depend on your surgeon’s training and a plastic surgeon’s availability. When appropriately selected, the risk of cancer recurrence in the nipple area is low.

Click here to see before and after photos of real people.

Related reading from Our Voices Blog:

Double (Bilateral) Mastectomy

Removes both breasts

This is often done for people with:

  • A high genetic risk (e.g., BRCA1 or BRCA2 mutation carriers)
  • Cancer in both breasts
  • A personal decision to reduce future cancer risk
Double (Bilateral) Mastectomy

Removes the entire breast, underlying chest wall muscles, and lymph nodes

This extensive surgery is rarely performed today and is typically reserved for:

  • Advanced breast cancer that has spread to the chest muscles
  • Select recurrent cases where other treatment options are limited

Coverage for Prophylactic Mastectomy
In Canada, prophylactic mastectomy is publicly funded for individuals with a BRCA mutation or those considered high risk. However, eligibility criteria vary by province. Speak with your healthcare provider to determine your coverage options.

Coverage also varies for patients with cancer in one breast who wish to remove the other. In most cases, the decision is made between the patient and physician based on individual circumstances.

Options After a Mastectomy

After a mastectomy, there are several ways to move forward based on your personal goals, comfort, and medical considerations. These include using a prosthetic, choosing breast reconstruction, or living flat/asymmetrical.

  • Prosthetics

    An artificial breast form that replaces the shape of a removed breast

    • Worn against the skin or inside the pocket of mastectomy bra
    • Against the skin it may feel sticky. Many people prefer a bra with built-in pockets
    • Can be matched in size and shape to your remaining breast
    • Needs to be replaced over time. Coverage may vary by province or insurance plan
    • Safe to use after radiation once skin is healed. Knitted Knockers of Canada offers free, temporary options
    • Swim prostheses are available for swimming

    Types of Prostheses

    • Temporary (Softie/Puff): Lightweight, often worn right after surgery. Soft, washable, and easy to adjust.
    • Permanent: Made of silicone or foam for long-term wear. Offers body symmetry and balance. Designed for use with mastectomy bras.

    Learn more about breast prostheses.

    The more modern materials give a more natural look and feel. No one will even know if they bump into you that you are wearing this”
    ~Andrea~

  • Reconstruction 

    Surgery to rebuild the shape of the breast after a mastectomy or lumpectomy  

    • Can use implants, your own tissue (flap), or a combination
    • May be done at the time of mastectomy (immediate) or months or years later (delayed)
    • Multiple procedures may be needed to achieve the desired result
    • Reduces the need for an external prosthesis

    Learn more about breast reconstruction.

    I chose to have immediate implant-based reconstruction for a number of reasons. I was 53 at the time of my diagnosis, was in good physical shape and proud of my appearance. My mother had a mastectomy at an early age and I always remembered her covering up in change rooms, and losing her silicon prosthetic at inconvenient times; for example, while swimming. I did not want to feel self-conscious and it was important for me to be able to wear a bathing suit or low-cut dress and appear natural. I felt it was critical to my self-esteem. Had I not been able to have an immediate reconstruction, I might not have agreed to more surgery later. I was glad the expanders could be inserted right after the mastectomy. Unfortunately, a lot of women are not able to have immediate reconstruction because of the difficulty of scheduling time in the operating room with the oncological surgeon and the plastic surgeon together. A word of advice: You will never look like you did pre-mastectomy; I still do not feel comfortable parading around naked except in front of my husband.”
    ~Karen~

    After two years of living flat I made the decision to undergo breast reconstruction. It wasn’t a decision that I took lightly, and I made sure that I was physically and emotionally ready.”
    ~Trisha~

    I think people need to be realistic in their expectations of reconstruction. What is your goal in doing it. A mastectomy takes away a part of who we are as a woman, both physically and psychologically. Getting back to feeling confident with or without reconstruction is a lot of work. Acceptance of the new you to start key. I know I felt I had no choice but to move forward with figuring it out. My breast was gone there was no grey area around that. Also knowing that reconstruction is not a simple procedure but can be painful at times but the end result worth it. I know many women who have not had reconstruction and they have found their sense of self as well.”
    ~Sondria~

  • Living Flat or Asymmetrical 

    Choosing not to have breast reconstruction and not wearing a breast prosthesis

    You may choose not to have breast reconstruction for many reasons, including:

    • Avoiding additional surgery
    • Reconstruction not being a safe or viable option
    • Concerns about recovery time or complications
    • Discomfort with wearing a prosthetic
    • Financial concerns - see financial assistance programs

    Choosing to remain flat is a valid and personal decision. Some people feel confident and free without reconstruction or a prosthesis, while others explore options gradually.

    For those with a larger breast size, living asymmetrically may affect posture, potentially causing back pain or balance issues. Talk to your healthcare team if this is a concern.

    Learn more about living flat or asymmetrical.

    Related reading from Our Voices Blog:

    I love being able to go flat, to lie on my stomach at night, to jog without bouncing, no hot boobs in the summer. I don't mind the scars, because to me it's like looking at an old, interesting gnarled and knotted tree. It shows life and strength and survival. Honestly, being flat is better than the original issue!”
    ~anonymous~

    I chose a single mastectomy with delayed reconstruction because I knew I would require radiation. Now that I am finished active treatment, it feels much more important to focus on recovering my stamina and strength. I may consider meeting with a plastic surgeon and get my options for reconstruction in a few years after I have had some time where I am strong. I need to feel physically and emotionally ready to attempt such a huge surgery. For now, it is enough that I am here cancer-free. My scar is a reminder every day to appreciate my life”
    ~Andrea~

    After my mastectomy I made the decision to go flat for about two years. I loved the feeling of not having to wear a bra. I found it extremely uncomfortable to wear prosthetic forms in a bra. Before cancer I had large breasts, but highly desired smaller ones, so my new figure was a welcomed change. I found adorable tops that were flattering and disguised a flat chest” 
    ~Trisha~

    I was very active and did not want my muscles cut into in order to create a breast. I was concerned about missing recurrences because of reconstruction and I basically had no issues about my body image with or without breasts. Women are very different on this topic and you need to consider the whole person and their attitude."
    ~anonymous~

Medical Reviews by Siba Haykal, MD, PhD, FRCSC, FACS, October 2025 and Mark Basik, MD, FRCSC, December 2025

References
Canadian Breast Cancer Network. (2022). Breast cancer and you: a guide for people living with breast cancer [PDF]. https://cbcn.ca/web/default/files/public/Reports/Breast%20Cancer%20and%20You_ENG_edit_web.pdf

Canadian Cancer Society. (2023). Breast prostheses. https://cancer.ca/en/cancer-information/cancer-types/breast/reconstruction-and-prostheses/breast-prostheses

Canadian Cancer Society. (2023). Breast reconstruction. https://cancer.ca/en/cancer-information/cancer-types/breast/reconstruction-and-prostheses/breast-reconstruction-surgery

Canadian Cancer Society. (2023). Choosing to remain flat. https://cancer.ca/en/cancer-information/cancer-types/breast/reconstruction-and-prostheses/choosing-to-remain-flat

Center for Restorative Breast Surgery. (n.d.). Nipple sparing mastectomy. https://www.breastcenter.com/breast-reconstruction-procedures/nipple-sparing-mastectomy/

Conner, K. (2025). Going flat after mastectomy. Breastcancer.org. https://www.breastcancer.org/treatment/surgery/going-flat-no-reconstruction

Galimberti, V., Vicini, E., Corso, G., Morigi, C., Fontana, S., Sacchini, V., & Veronesi, P. (2017). Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications. Breast (Edinburgh, Scotland), 34 Suppl 1(Suppl 1), S82–S84. https://doi.org/10.1016/j.breast.2017.06.034

Knitted Knockers Canada. (2025). Soft, comfortable, knit prosthetics for breast cancer survivors. https://knittedknockerscanada.com/

National Cancer Institute. (2025). Breast reconstruction after mastectomy. National Institutes of Health. https://www.cancer.gov/types/breast/reconstruction-fact-sheet

Nelson, R. (n.d.). Nipple sparing mastectomy: Tips & tricks. BC Cancer. http://www.bccancer.bc.ca/surgical-oncology-network-site/Documents/Rebecca%20Nelson%20-%20Nipple%20Sparing%20Mastectomy%20Tips%20and%20Tricks.pdf

Susan G. Komen. (2025). Breast reconstruction. https://www.komen.org/breast-cancer/treatment/type/surgery/breast-reconstruction/

Uscher, J. (2024). Types of mastectomy. Breastcancer.org. https://www.breastcancer.org/treatment/surgery/mastectomy/types

Wu, Z. Y., Kim, H. J., Lee, J. W., Chung, I. Y., Kim, J. S., Lee, S. B., Son, B. H., Eom, J. S., Kim, S. B., Gong, G. Y., Kim, H. H., Ahn, S. H., & Ko, B. (2019). Breast cancer recurrence in the nipple-areola complex after nipple-sparing mastectomy with immediate breast reconstruction for invasive breast cancer. JAMA Surgery, 154(11), 1030–1037. https://doi.org/10.1001/jamasurg.2019.2959