Skin-sparing mastectomy: This procedure—and a variation of it called nipple-sparing mastectomy—are the most commonly performed types of mastectomy today. In skin-sparing mastectomy, the breast tissue, nipple, and areola are removed, but most of the skin over the breast is left intact. This procedure is done only when breast reconstruction is performed at the same time as the mastectomy. It may not be possible to save the skin if the tumor is near or involving the surface of the breast.
Nipple-sparing mastectomy: In this procedure, the breast tissue is removed, but the breast skin, nipple, and areola are saved. A biopsy is usually taken of the tissue directly beneath the nipple, and then the tissue is examined under a microscope by a pathologist to confirm that there are no cancer cells present. Nipple-sparing mastectomy may not be possible or advisable if there are issues with blood supply to the nipple region, if the tumor is very close to or involving the nipple, or if the nipple is not in a good position for reconstruction.
Nipple-sparing mastectomy can only be done for women who choose immediate breast reconstruction at the time of mastectomy and can’t be done as a delayed procedure.
Partial mastectomy: Also known as lumpectomy or breast conservation surgery, this is a procedure that removes the tumor (“lump”) along with some of the surrounding normal breast tissue, while the remaining part of the breast is left intact. This surgery is usually followed by radiation therapy to reduce the risk of cancer recurring in the remaining breast tissue.
Total (simple) mastectomy: In a total mastectomy, also known as a simple mastectomy, the entire breast is removed, including the excess skin, the nipple, and the areola. It is the most common technique used when reconstruction is not being performed.
Radical mastectomy: This was once the standard operation for breast cancer, but it’s now performed only rarely, when the cancer has spread to the chest muscles. As in the total mastectomy, the entire breast along with the skin, nipple, and areola are removed. In addition, the lymph nodes in the underarm area and the chest muscles are taken out.