A mastectomy is a breast cancer surgery in which the entire breast is removed. You may need a total mastectomy if you have inflammatory breast cancer, an inability to undergo radiation therapy, multicentricity (more than one cancer in more than one quadrant of the breast), or an abnormally large tumor. There are multiple types of mastectomies. 
 
1) Conventional Mastectomy 
A Conventional Mastectomy involves removing the entire breast, including the nipple and the skin. Surgeons may also perform a sentinel node biopsy, and remove a few axillary lymph nodes. Although a mastectomy will leave you flat, reconstructive surgery will most likely be an option in the future.
Who can get simple mastectomy? 
-women with breast cancer with micrometastesis (.2-2mm of cancer) in the sentinel lymph nodes 
-women with DCIS or LCIS
-patient preference (peace of mind, etc.) 
-those who cannot have breast conserving surgery due to their inability to undergo radiation therapy (previous radiation therapy, collagen vascular disorders, etc). 
​
2) Modified Radical Mastectomy 
A modified radical mastectomy includes the removal of the breast tissue, the nipple and areola, the skin, and the axillary lymph nodes, which are the lymph nodes in the armpit (this is called an axillary lymph node dissection, or ALND). 
Who should have a MRM? 
This surgery is common for those with inflammatory breast cancer.  An MRM may also be performed if your breast cancer has spread to multiple lymph nodes, in order to remove the cancer in the breast and in the lymph nodes at the same time. 
​
3) Radical Mastectomy 
A radical mastectomy is a surgery in which the breast tissue, nipple and areola, the skin, the axillary lymph nodes, AND the pectoralis (chest) muscles are removed.
Who should have a Radical Mastectomy? 
This type of surgery is usually only performed if the tumor is growing into the muscles of the chest. Although it used to be the standard of treatment, it is now very rare, as it has a similar survival outcome to a modified radical mastectomy, which is much less invasive. 
​
4) Skin Sparing Mastectomy 
A skin sparing mastectomy is a procedure in which the breast tissue, the nipple, and the areola are removed, but the skin around the breast is left in place. This surgery also involves immediate reconstruction, either with an implant or with autologous reconstruction (in which your own muscle, fat, and/or skin will be used to reconstruct the breast). 
Who can have a SSM? 
An SSM is NOT a possible treatment option for those with inflammatory breast cancer (because it involves the skin), and will most likely not be possible for those with tumors close to the skin or very large tumors. However, this surgery is most likely a possibility for most other women, and is advantageous because it involves less scar tissue and looks very natural. 

5) Nipple Sparing Mastectomy 
A nipple sparing mastectomy is a surgery in which the breast tissue is removed, but the skin, nipple, and areola are left behind. During this surgery, the surgeon will test the breast tissue behind your nipple for cancer; if it is positive, the nipple and aerola must be taken out.
Who can have a NSM? 
To assess if you can have an NSM, your doctor will consider the extent of your cancer and the proximity of the cancer to the nipple. For example, those with a small, early stage cancer far away from the nipple will most likely qualify for an NSM. However, those who have Paget's Disease (cancer in the nipple), ptosis, or large tumors will most likely be ineligible. 

6) Contralateral Prophylactic (Double) Mastectomy 
A double mastectomy involves the removal of both breasts.
Who should have a double mastectomy? 
-Those with cancer in both breasts
-Some women with cancer in one breast:
Women who have unilateral breast cancer (cancer in one breast) have a 0.5-1% risk per year of developing breast cancer in the other breast. Although this may seem like an insignificant number, if a 30 year old is diagnosed with unilateral breast cancer, by the time they turn 80, that risk will have increased to 25-50%.  A prophylactic mastectomy will reduce that risk by 95%. Therefore, younger women diagnosed with unilateral breast cancer may consider a CPM to reduce their risk of cancer in their other breast in the future. 
-Women with high risk mutations: 
Women with a very high risk for breast cancer, due to a mutation such as BCRA 1 or 2 may also choose to have a double mastectomy.
-peace of mind
-ease in follow up for those with history of unilateral cancer (less frequent surveillance)