Mastectomy (breast removal)

Mastectomy removes the entire breast gland, usually together with the areola and nipple. It is offered when the tumour is too large relative to the size of the breast, when there are several tumour sites in the breast, when radiotherapy is not possible, or in case of recurrence after breast-conserving surgery. Some patients also choose it after full information. Depending on the case, the armpit is assessed using the sentinel node technique or by axillary clearance, which removes the lymph nodes from the armpit. In some situations, the skin, and even the areola and nipple, can be preserved to make reconstruction easier. Breast reconstruction is part of the plan from the outset. It can be performed during the same operation (immediate reconstruction) or later, once treatments are completed (delayed reconstruction), using an implant or the patient's own tissue. It is discussed with the clinic's plastic surgeons. Some women prefer not to have reconstruction; an external breast prosthesis is then offered. At Clinique Pasteur Tunis, the decision is made at a multidisciplinary team meeting and explained to the patient in a dedicated consultation. The care team supports her before and after the operation, including psychologically, as this surgery affects body image.