Mastectomy (mammary ablation) is the surgical removal of the mammary gland with or without underlying fascia. Underlying musculature is not removed.
For invasive cancer and DCIS grade 3, a sentinel node biopsy is performed before a mastectomy.
Axillary lymph node dissection is performed when preoperative spreading in the axilla is present, or for locally advanced disease when spreading in the axilla is present before preoperative treatment. In addition axillary lymph node dissection is performed for locally advanced cancer with skin involment. Or for T-3 tumors when there is little or no tumor response after preoperative treatment, regardless of preoperative axillary status.
- When breast-conserving surgery is not indicated, or not wanted by the patient.
- When radiation therapy is not feasible.
- Palliative for local control (with metastases)