Introduction: Breast cancer is the most prevalent cancer in women and among the leading causes of cancer death worldwide. Despite the fact that screening, systemic treatment, and targeted biologic agents have transformed clinical practice, surgery continues to be the foundation of curative treatment. Mastectomy—the surgical removal of part or all of the breast—is still an alive and well option, not only in the therapeutic arena but also for those women at high genetic risk. Indications range from locally advanced and multicentric tumors and previous failed breast-conserving surgery and patient preference to hereditary mutations such as BRCA1 and BRCA2. Over the past few years, reconstructive strategies and surgical techniques have changed, and emphasis has moved from mere survival to quality of life and psychosocial rehabilitation.
Methods: This review is drawn from peer-reviewed publications, clinical guidelines, and meta-analyses from 2015 to 2025. Articles were selected for inclusion if they addressed surgical outcomes, reconstructive options, and patient-reported outcomes following mastectomy. Of special interest was comparing and contrasting the traditional mastectomy, modified radical mastectomy, and skin- or nipple-sparing procedures. Survival rates, complication profiles, and quality-of-life data were amalgamated alongside reports of multidisciplinary care among oncologists, surgeons, radiologists, and psycho-oncology specialists.
Results: Mastectomy, throughout the literature, continues to provide excellent local control of breast cancer. Survival in the majority of series was equivalent to breast-conserving therapy when combined with modern systemic therapy. Skin- and nipple-sparing procedures, when applied in appropriately selected patients, provided excellent cosmetic results without compromising cancer control. Immediate or delayed reconstruction was also associated with higher levels of satisfaction and body image improvement, though complications such as lymphedema, chronic pain, and wound infection remain considerations. Studies also focused on patient-centered decision-making, with individualized treatment planning leading to better adherence and long-term satisfaction.
Conclusion: Mastectomy remains a pillar of breast cancer surgery. Evolving techniques have not only improved oncologic safety but also expanded the mission of care to encompass psychosocial well-being and long-term quality of life. The integration of reconstructive surgery, minimally invasive procedures, and supportive care services has transformed the patient experience. Advances in the future will depend on precision medicine, shared decision-making, and continued multidisciplinary collaboration to reduce complications and provide comprehensive, patient-centered care.
Keywords: Breast cancer, mastectomy, surgery, breast reconstruction, quality of life