Mastectomy in Jaipur

What mastectomy is and why it is done

Mastectomy is the surgical removal of the breast tissue to treat or prevent breast cancer. In a unilateral mastectomy one breast is removed; in a bilateral mastectomy both breasts are removed. The operation may also include removal of lymph nodes from the armpit to check whether cancer has spread.

A modified radical mastectomy removes the breast and the axillary lymph nodes together. A simple mastectomy with sentinel node biopsy removes the breast and tests only the first draining nodes. Breast-conserving surgery removes only the tumour and a margin of healthy tissue and is usually followed by radiotherapy. Your surgeon will advise which approach suits your condition.

Symptoms of breast cancer and warning signs that need urgent care

Common symptoms include:

• A lump in the breast or armpit
• Change in breast size or shape
• Skin dimpling or redness
• Nipple inversion or discharge
• Persistent pain in one spot

Warning signs that need medical attention the same day are a rapidly growing lump, sudden swelling or redness of the breast, fever with breast pain, an open wound or ulcer on the breast skin, and shortness of breath or chest pain. If you notice any of these, contact your doctor or go to the emergency department without delay.

Causes and who is at higher risk

Breast cancer develops when cells in the breast grow out of control.

Exact causes are not always known, but risk increases with age, a personal or family history of breast or ovarian cancer, certain inherited gene changes, early menstruation or late menopause, having no children or a first child after age 30, hormone replacement therapy, obesity after menopause, and alcohol use.

In some cases mastectomy is also performed as a preventative measure for women believed to have a high risk of cancer. Having one or more risk factors does not mean you will get cancer; many people with risk factors never develop it.

How breast cancer is diagnosed: examination and tests

Diagnosis starts with a clinical breast examination. Imaging tests such as mammography, ultrasound, or MRI help to see the tumour. A biopsy takes a small tissue sample to confirm cancer and its type.

If cancer is found, further tests like blood tests, chest X-ray, CT scan, PET scan, or bone scan may be done to check the stage and whether it has spread. Your doctor uses this information to tell the stage of cancer and plan your treatment. A sentinel lymph node biopsy is often done during surgery to see if cancer has reached the armpit nodes.

Treatment options without surgery and when surgery is advised

Non-surgical treatments include:

• Chemotherapy
• Hormonal therapy
• Targeted therapy
• Immunotherapy
• Radiotherapy

These may be given before surgery to shrink a tumour or after surgery to lower the risk of recurrence.

Surgery is advised when the tumour is large relative to the breast, when there are multiple tumours in different areas of the breast, when cancer involves the nipple or skin, when previous radiotherapy makes breast-conserving surgery unsafe, or when a patient chooses mastectomy over breast-conserving surgery. Indications for mastectomy include carcinoma or DCIS that require mastectomy, including after neoadjuvant chemotherapy.

The choice depends on the cancer stage, tumour features, your overall health, and your preference. Your surgical team will discuss the options with you.

Preparing for mastectomy surgery

Before your mastectomy, the surgical team at Jaipur Hospital will arrange a series of tests to check your fitness for general anaesthesia and to plan the operation.

These usually include:

• Blood tests
• A chest X-ray
• An ECG
• Imaging of the breast and armpit

The results help your surgeon decide which technique is suitable and whether you need any medicine adjustments.

You should tell your doctor about every medicine you take, including blood thinners, aspirin, herbal products, and supplements. Some of these may need to be stopped a few days before surgery to reduce bleeding risk. Your anaesthetist will review your list and give clear instructions on what to take on the morning of the operation.

You will be asked to fast for at least six hours before the procedure. This means no food, milk, or tea with milk. Clear water may be allowed up to two hours before you come to the hospital; the nursing staff will confirm the exact timing.

Pack a small bag for a stay of two to four nights. Bring loose, front-opening shirts or kurtas that are easy to put on without raising your arms, comfortable trousers, underwear, and a soft bra or camisole without underwire.

Include your regular medicines, a list of allergies, your insurance or scheme cards (RGHS, MAA Yojana, CGHS, or private insurer details), and a phone charger. An attendant can stay with you in the room.

How mastectomy surgery is done

Mastectomy is the surgical removal of the breast to treat or prevent breast cancer. The operation is performed under general anaesthesia and usually takes two to three hours. During the surgery, the surgeon injects numbing medication into the surrounding tissues to help with pain control after you wake up.

Your surgeon will discuss which technique fits your cancer stage, tumour location, and personal preference. The main options are:

• Modified radical mastectomy: The whole breast and the lymph nodes in the armpit are removed.
• Simple mastectomy with sentinel node biopsy: The breast is removed and only the first draining lymph nodes are tested. If those nodes are clear, no further nodes are taken.
• Breast-conserving surgery: Only the tumour and a margin of healthy tissue are removed, followed by radiotherapy to the breast. This is not a mastectomy but is offered when the cancer is small and suitable.

Skin-sparing and nipple-sparing approaches keep most of the breast skin or the nipple-areola complex to allow immediate reconstruction. These are usually done together with reconstruction using an implant, a tissue expander, or your own tissue from another part of the body.

Because the incision is smaller, these operations should be performed by experienced breast surgeons working closely with a plastic surgeon.

During the operation, the surgeon may also remove a small part of the chest muscle only if the cancer is near or touching it. Most surgeries do not harm the chest muscles. Lymph nodes are assessed by sentinel node biopsy using a blue dye, a radiotracer, or both to locate the first nodes.

If cancer is found in the sentinel nodes, further surgery to remove more nodes may be needed, either at the same time or later. You will wake up with at least one drain in place to collect fluid; typically one drain per side is used, sometimes two.

Risks and possible complications of mastectomy

Mastectomy is a major operation and, like all surgery, carries risks. In studies, the overall pooled complication rate after mastectomy with reconstruction was about 22 percent. Complication rates vary with the type of reconstruction: two-stage expander-to-implant reconstruction had a complication rate of about 53 percent, one-stage direct-to-implant reconstruction about 17 percent, and autologous (own tissue) reconstruction about 24 percent.

Specific complications include:

• Wound infection
• Bleeding
• Seroma (fluid build-up)
• Poor wound healing

Nipple necrosis (loss of the nipple) is a key concern when the nipple is preserved. In studies, the overall nipple necrosis rate was about 7 percent. It varied by incision type: radial incision about 9 percent, periareolar or circumareolar about 18 percent, inframammary about 9 percent, mastopexy-type about 5 percent, and transareolar very high at about 82 percent.

With two-stage expander-to-implant reconstruction the nipple necrosis rate was about 4.5 percent, with one-stage direct-to-implant about 4 percent, and with autologous reconstruction about 17 percent. Surgeon experience reduces these rates over time.

Factors that increase the risk of complications include large or ptotic (drooping) breasts, smoking, obesity, and previous or planned radiotherapy. If you smoke, stopping several weeks before surgery lowers your risk.

After mastectomy you will not be able to breastfeed on that side, and you will lose sensation in the breast skin. Some people experience phantom sensations — feeling as if the breast or nipple is still there — along with tenderness, numbness, or twinges in the chest wall or arm. These usually become less frequent over the first few months.

Lymph node removal can lead to lymphoedema (arm swelling), shoulder stiffness, or numbness in the inner upper arm. Sentinel node biopsy carries a lower risk of lymphoedema than full axillary dissection. Your team will discuss exercises and precautions to reduce these risks.

Recovery and aftercare after mastectomy

After the operation you will spend a few hours in the recovery area before moving to your room. The typical hospital stay at Jaipur Hospital is two to four nights. If you have immediate autologous reconstruction, the stay may be longer, up to four or five days. Some patients go home the same day or after an overnight stay when no reconstruction is done.

You will have one or more drains attached to a small bottle. The nursing team will show you and your attendant how to empty the drain and measure the output. A drain is usually removed once the output drops below 20 to 30 millilitres per day for two days in a row.

The average time a drain stays in place is two to three weeks. You may go home with the drain still in; the surgical team will arrange a follow-up visit for drain removal.

Pain is usually controlled with regular paracetamol or ibuprofen. Some people need a stronger painkiller for a short period. You will be advised to avoid heavy lifting and to avoid raising the arm above shoulder height on the operated side until the drains are removed, to prevent dislodging the drain or any spacer.

Do not drive until your surgeon clears you, and not while you are taking strong pain medication. Avoid swimming or soaking in a bath for at least six weeks or until the incision is completely healed.

Recovery time before returning to normal activity is typically three to six weeks. Without reconstruction, healing is closer to three weeks; with reconstruction, it is usually four to six weeks. You will see your surgeon for a wound check and to discuss the pathology report, which guides any further treatment such as chemotherapy, radiotherapy, or hormone therapy.

Call the hospital or visit the emergency department if you develop a fever above 38°C, increasing redness or warmth around the wound, sudden swelling or pain in the arm, drain output that suddenly increases or becomes foul-smelling, or if you feel unwell in any other way.

Results of mastectomy: how well it works and recurrence rates

In long-term studies comparing modified radical mastectomy with breast-conserving therapy (lumpectomy plus radiotherapy), local control was better with mastectomy, but overall survival and time to distant metastases were not significantly different. This means both approaches offer similar life expectancy for suitable patients.

For women who had axillary dissection and no positive nodes, adding radiotherapy did not significantly reduce locoregional recurrence or breast cancer mortality. For women with one to three positive nodes, radiotherapy reduced locoregional recurrence, overall recurrence, and breast cancer mortality. In node-positive disease, radiotherapy also reduced overall mortality.

Studies of skin-sparing and nipple-sparing mastectomies show that cancer outcomes do not differ from non-conservative mastectomies. Recurrence rates in the nipple-areola complex after nipple-sparing mastectomy are reported as acceptably low, ranging from 0 to 3.7 percent. Patient satisfaction and psychological adjustment are generally high with nipple-sparing techniques.

In one large trial with over 20 years of follow-up, the 20-year overall survival was about 44 percent in the mastectomy group and about 39 percent in the breast-conserving group; the difference was not statistically significant. Distant metastasis rates at 20 years were about 43 percent and 47 percent respectively.

Your individual outcome depends on the cancer stage, tumour biology, and any additional treatments you receive. The pathology report after surgery gives the clearest picture of your risk of recurrence. Your oncology team will explain what the results mean for you.

Cost and insurance for mastectomy in Jaipur

The typical price range for mastectomy surgery in India is ₹1,00,000 to ₹2,50,000. This range covers the operation, anaesthesia, hospital stay of two to four nights, and basic investigations.

The final cost depends on several factors:

• The type of mastectomy (modified radical, simple with sentinel node, or skin- or nipple-sparing)
• Whether reconstruction is done at the same time or later
• The choice of implant or autologous tissue
• The length of stay in the intensive care unit or ward
• The number and type of pre-operative tests required

When both breasts are removed, the cost increases.

Breast reconstruction after mastectomy typically costs an additional ₹70,000 to ₹1,50,000, depending on the method. Reconstruction can be done immediately during the mastectomy or delayed until after other cancer treatments are complete. If radiotherapy is needed, doctors often advise waiting until treatment finishes before reconstruction.

Mastectomy is considered a medically necessary procedure, so its cost is usually covered by health insurance. Coverage may be partial or complete depending on your policy terms and the reason for surgery. Jaipur Hospital is empaneled under RGHS, MAA Yojana, CGHS, and a panel of private insurers and TPAs.

Bring your scheme or insurance card and any pre-authorisation letters at admission. The hospital’s insurance desk will help you with the paperwork and cashless or reimbursement processes. For a personalised estimate, please contact the hospital directly.