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A mastectomy is a type of surgery that removes breast tissue. There are a few different types of mastectomy procedures that can be performed depending on your age, breast tissue, tumour size and location and the presence of cancer in surrounding tissue and lymph nodes, including radical mastectomy, total mastectomy and double mastectomy. The aim of a mastectomy procedure is to remove the tumour (either wholly or partially), and surrounding skin that could possibly have cancer cells in them, to prevent cancer from returning or spreading. 

Another term you may have heard of is a lumpectomy, which is where the tumour is removed and a small amount of surrounding tissue. Technically a lumpectomy is a type of mastectomy. 

A mastectomy is indicated for people who have been diagnosed with breast cancer. Surgical removal of the tumour is currently the standard treatment for best recovery rate. For those who have low-grade breast cancer (stage 0 to 1), surgery may be the only required treatment. 

People with high genetic risk of breast cancer, such as those with strong family history of breast cancer, or are BRCA positive (a type of gene that increases the risk of ovarian and breast cancer) may opt to have a preventive mastectomy or double mastectomy. There have been a few famous women in the last decade who have had preventative double mastectomies due to their genetic risk, prompting an increase in this type of pre-emptive surgery.

For some people, they may have been recommended a lumpectomy, but due to the nature of the tumour, or their breasts, a mastectomy may be more beneficial. Women with small breasts, for example, may more be left with enough breast tissue after a lumpectomy; therefore a reconstructive mastectomy would be deemed more appropriate. 

A single mastectomy is the removal of a single breast, typically the breast where the tumour resides in. Low-grade breast cancer or low genetic risk of breast cancer will usually lead to a single mastectomy or lumpectomy. 

A double mastectomy, on the other hand, is the removal of both breasts. A double mastectomy is usually requested if the tumour has spread to surrounding breast tissue or the other breast, if the patient has a high familial risk of breast cancer, if the patient is BRCA positive, or if the breast cancer high-grade or recurrent. 

Double mastectomies have received a lot of attention in the media recently with high profile people, notably Angelina Jolie, choosing to have a preventative double mastectomy. The latest research has found that women, due to fear, are now requesting double mastectomies even though they are not required. 

Angelina Jolie is BRCA positive. BRCA is a type of gene that is inherited from parent to child. It is predominantly seen in the Ashkenazi Jewish population, and in other demographics such as in Iceland and Norway.

Many women may feel that they would prefer a double mastectomy, but research has found that unless indicated, having a double mastectomy may be unnecessary and doesn’t reduce breast cancer recurring versus current medication and monitoring. Your doctor will be able to give you more information if you think you may be suitable for a double mastectomy.

Your mastectomy aftercare will depend on what type of mastectomy you had. In general, you may find the area a bit sore and bruised post surgery, and movement slightly limited. Fluid can also collect in the area, especially if you have had surrounding lymph nodes removed, so you may find yourself with drain tubes attached. 

Mastectomy aftercare will also depend on what country you live in and what type of health care system is available. In some countries, people may find themselves staying in the hospital for up to a week after their mastectomy, while in other countries a simple lumpectomy may be a day procedure. 

With any type of surgery, there is a risk of getting an infection. It is pivotal you know the signs of infection and report them to the doctor should you start experiencing any of them. 

It is important to get your arm and chest moving again, but slowly and gently. You will most likely be prescribed some exercises to begin after your operation; it is important to stick to these, within reason, to ensure you gain full mobility back to your arm and chest area following your mastectomy.

A mastectomy is a type of surgery. And with all surgeries, there is usually some discomfort involved immediately after, and up to a few weeks following your surgery. Your doctor will give you some pain relief medication to take after your mastectomy surgery, and it is important to take them when prescribed to ensure your pain does not go above the tolerable threshold. Pain though can be a sign of infection, so if you do find the area being increasingly sore, and not responding to pain relief, it is important to inform your doctor immediately to prevent you becoming unwell. 

A reconstructive mastectomy is a type of mastectomy where the breast is reconstructed after the breast tissue is removed. The reconstructed breast can be made from surrounding muscle or fat, or implants can be put in. 

Reconstructive mastectomies are a great alternative for people who are self-conscious about not having a breast, and are well enough to have the procedure. Reconstruction surgery can also occur at a later date (after the mastectomy). 

The type of mastectomy surgery and length of healing will affect when you can resume wearing a bra. Bras can cause friction by rubbing which can annoy the area and lead to wound breakdown, so it is best to wait for the wound to heal before you start wearing a bra. Your doctor or breast care nurse will be able to provide you with more advice about when to start wearing a bra again.

This is a difficult question to answer. The aim of a mastectomy is to remove all or partially remove the tumour in the breast tissue. If the entire tumour is removed and it is low-grade (i.e. it has not spread anywhere else), there is low chance the tumour will return. However, as with all things cancer, there are no certainties. It is important to follow your doctor’s instructions regarding checks up and monitoring to minimise the chances of your cancer returning.


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