Surgical Procedures: Modified Radical Mastectomy
Also referred to as: Mastectomy and axillary lymph node dissection, MRM, Skin sparing modified radical mastectomy with same day breast reconstruction
What is a Modified Radical Mastectomy?
A modified radical mastectomy is the removal of the entire breast. This includes the nipple, areola (area around the nipple), breast tissue and the majority of lymph nodes from under the arm, which may be called an axillary lymph node dissection.
Will I stay overnight?
Yes. Most people will stay in the hospital for one or more days. Your stay may be longer if you have breast reconstruction.
What is recovery like?
Your surgeon will talk to you about specific recovery issues. In general, you will be up and moving the day after surgery. You will have some limitations to your normal schedule and exercise routine in the first week or so. Surgical drains, placed at the time of surgery, are used to remove fluid that builds up in the area after the procedure. They are placed under the arm on the side of surgery and stay in for about 7-10 days. When ready, they are removed in the provider’s office. You will be given instructions on how to take care of the drain at home. After surgery, you could have any of the following:
- Pain and/or sensitivity along the chest wall, reconstructed breast, underarm area, or back of the upper arm.
- Numbness along the chest wall or reconstructed breast. This numbness puts you at risk for a serious burn. Do not use heating pads or hot packs on this area. If you have concerns, please discuss this with your healthcare team.
- After the drain is removed, a seroma could develop. A seroma is a buildup of fluid under the arm. It is not worrisome, but can be uncomfortable. Most go away naturally, over time. In some cases, they need to be drained in the office with a needle.
- Lymphedema, a chronic swelling in the arm and/or breast on the side of surgery. Discuss your risk of lymphedema with your surgical team. Learn more about lymphedema and what you can do to minimize your risk of developing lymphedema.
Can I prevent infections?
Getting an infection after this procedure is not common. You can help prevent an infection by:
- Take a shower the night before surgery and wash your body with soap and water.
- On the second day after surgery, make sure to shower or at least clean the incision with soap and water. Pat dry, do not rub the incision. Do this every day, or at least every other day, to keep the incision site clean.
- Do not immerse the incision site in water (soaking in a tub or swimming).
- Always wash your hands before and after touching the incision or changing the dressing.
What will I need at home?
- Gauze pads (4x4) to cover the drain, abdominal pads (also called surgi-pads) to place across your chest wall or reconstructed breast for padding/comfort, and 1-inch paper tape. These can be all be found at your supermarket or pharmacy.
- A specimen cup to measure fluid from the drain. This should be given to you by hospital staff before going home.
- Clean, supportive pillow(s) to put under your arm while sitting or to help with positioning at night.
- You may have constipation after surgery. Over-the-counter medications, adding fiber to your diet, exercise (as simple as walking) and fluids may ease constipation. Ask your health-care team about over-the-counter medications that may work for you.
Care of the Incision
If you have a post-surgical bandage, remove per your surgeon's instructions (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Avoid lotions, powders or deodorant on or near the incision during the first 1-2 weeks, until it is fully closed.
Most surgeons use dissolvable sutures inside your body, which will go away on their own. On the outside, your surgeon may use surgical glue, paper tape called "steri-strips" or nothing at all. Both glue and steri-strips can get wet in the shower.
How can I care for myself?
You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.
Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.
There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.
Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.
- Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.
This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.