At a glance
A mastectomy is a surgical operation to remove one or both breasts, most often performed to treat or prevent breast cancer.
During the procedure, the surgeon removes breast tissue and, depending on the type of mastectomy chosen, may also remove the nipple, overlying skin, and nearby lymph nodes (small glands that are part of the immune system). Removing the tissue eliminates cancerous cells or, in high-risk patients, reduces the chance that cancer will develop in the future.
Medical Condition
Mastectomy is recommended when breast cancer cannot safely be removed with a smaller operation, or when a patient chooses it over repeated radiation treatments.
- Invasive breast cancer (cancer that has grown into surrounding breast tissue) that is too large or widespread for a partial removal
- Inflammatory breast cancer (an aggressive type where cancer cells block lymph vessels in the skin)
- Locally recurrent breast cancer after a previous lumpectomy (removal of only the tumour)
- Multiple tumours in different parts of the same breast
- Positive BRCA1 or BRCA2 gene mutations in patients who want to lower their future cancer risk (prophylactic mastectomy)
- Ductal carcinoma in situ (DCIS, a very early-stage cancer confined to the milk ducts) covering a large area of the breast
- Paget's disease of the breast (a rare cancer affecting the nipple and areola)
Mastectomy is generally not the first choice when the tumour is small and located in one area, because a lumpectomy followed by radiation often produces the same survival outcome with less tissue removed. Patients who cannot undergo general anaesthesia safely due to serious heart or lung conditions may also not be suitable candidates, and their doctors will discuss safer alternatives.
Risks & Complications
Mastectomy is a major operation and carries real risks, though serious complications are not the norm for most patients.
- Pain and tenderness at the incision site in the days and weeks after surgery
- Wound infection, signalled by redness, warmth, swelling, or discharge
- Seroma (a pocket of fluid that collects under the skin after the breast tissue is removed), which may need to be drained
- Haematoma (a pool of blood under the skin), which can cause bruising and swelling
- Lymphoedema (long-term swelling of the arm) if lymph nodes are removed and the drainage system is disrupted
- Numbness or altered sensation in the chest wall, arm, or armpit
- Limited movement in the shoulder or arm, especially in the first weeks
- Reactions to general anaesthesia, such as nausea or, rarely, breathing difficulties
- Blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), a risk with any major surgery
- If breast reconstruction is performed at the same time, additional risks specific to the reconstruction method apply
Preparation & Procedure
In the days before surgery, the medical team typically asks patients to stop blood-thinning medications and certain supplements, because these increase bleeding risk. Smoking reduces blood flow to healing tissue, so most surgeons ask patients to stop well before the operation. Alcohol should also be avoided in the days leading up to surgery.
Standard pre-operative tests usually include a blood panel to check general health, a chest X-ray, an electrocardiogram (EKG, a recording of the heart's electrical activity), and imaging of the breast such as a mammogram or MRI. If reconstruction is planned, the plastic surgeon will also take measurements and photographs.
From midnight before the surgery, patients are usually asked to eat and drink nothing, including water. Specific fasting instructions will be confirmed by the hospital team.
- 1. Admission and paperwork: the patient checks in, signs consent forms, and meets the anaesthesia team.
- 2. Preparation: a cannula (a thin tube) is placed in a vein for fluids and medications, and the surgical site is cleaned and marked.
- 3. Anaesthesia: general anaesthesia is given, so the patient is completely asleep and feels nothing during the operation.
- 4. Incision: the surgeon makes a cut across the breast, with the shape and location depending on the type of mastectomy and whether reconstruction is planned.
- 5. Tissue removal: breast tissue is carefully separated from the chest muscle and skin, then removed. Lymph nodes may be removed at this stage through a separate small incision in the armpit.
- 6. Drain placement: one or two thin drainage tubes are usually left in place to prevent fluid build-up under the skin.
- 7. Closure: the incision is closed with stitches, staples, or adhesive strips, and a dressing is applied.
- 8. Recovery room: the patient is moved to a monitored recovery area until the anaesthesia wears off.
Aftercare
Most patients stay in hospital for one to three nights after a mastectomy, though this varies with the type of procedure and whether reconstruction was performed at the same time. The nursing team monitors blood pressure, wound healing, and drainage output before discharge.
- Drainage tubes are usually kept in place for several days and removed once fluid output drops to an acceptable level; patients are taught to empty and record the drain at home.
- Pain is managed with prescribed pain relief; the level of discomfort typically decreases steadily over the first two weeks.
- The wound dressing should be kept dry and changed as directed by the surgical team.
- Heavy lifting, reaching above the shoulder, and strenuous activity are usually restricted for several weeks.
- Arm and shoulder exercises, introduced gradually, help prevent stiffness and support lymph drainage.
- A follow-up appointment is typically scheduled within one to two weeks to check the wound, remove stitches or staples, and discuss pathology results (the laboratory analysis of removed tissue).
- If chemotherapy or radiotherapy is planned, this usually begins after the wound has healed, and the oncologist (cancer specialist) will set the timeline.
- Patients who had lymph nodes removed should watch for signs of lymphoedema (arm swelling, heaviness, or tightness) and report them promptly.
- Emotional support through counselling or breast cancer support groups is encouraged, as adjusting to body image changes takes time for many patients.
- Long-term follow-up with the oncology team continues after discharge, with the frequency of appointments depending on the stage of disease and treatment plan.
Cost & What Determines It
The cost of a mastectomy varies widely depending on how complex the surgery is, where it is performed, and what additional procedures are carried out at the same time. No two patients face exactly the same bill, because the details of each case differ.
- Type of mastectomy: a simple mastectomy (breast tissue only) costs less than a modified radical mastectomy (which also removes lymph nodes) or a skin-sparing or nipple-sparing technique.
- Reconstruction: immediate breast reconstruction performed at the same operation adds surgeon fees, implant or tissue-flap costs, and a longer operating time.
- Hospital class and country: private hospitals in medical-travel destinations charge differently from government or university hospitals, and pricing varies considerably between countries.
- Length of stay: more nights in hospital, especially after combined mastectomy and reconstruction, increase accommodation and nursing fees.
- Implants or expanders: if a silicone implant or tissue expander is used during reconstruction, the device itself carries a significant cost.
- Pathology and additional imaging: laboratory analysis of removed tissue, sentinel node biopsy (testing the first lymph node that drains the tumour), and post-operative scans are often billed separately.
- Anaesthesia: the anaesthetist's fee is usually charged separately and depends on the duration of the operation.
- Oncology consultations and follow-up treatment: if chemotherapy or radiotherapy follows, those costs are separate from the surgical bill.
A hospital package for mastectomy typically covers the surgeon's fee, operating theatre use, anaesthesia, the hospital stay, standard medications during admission, and basic nursing care. Items that are commonly billed outside the package include the pathology report, any implants used, pre-operative tests ordered after admission, physiotherapy sessions, and outpatient follow-up visits.
BPJS Kesehatan does not cover treatment received abroad, and most Indonesian private health insurance policies also exclude overseas procedures. Patients travelling for a mastectomy usually pay out of pocket or through an international private insurance plan that explicitly covers treatment outside Indonesia. Requesting a written cost estimate from the hospital before travelling is the practical way to understand the full expected spend and avoid unexpected charges on discharge.
Frequently Asked Questions
How long does a mastectomy operation take?
A mastectomy usually takes between one and three hours, depending on how much tissue is removed and whether reconstruction is done at the same time. A simple removal of one breast tends to be shorter, while a bilateral mastectomy (removal of both breasts) or one combined with immediate reconstruction takes longer. Your surgical team will give you a more specific estimate once they have reviewed your case.
How much does a mastectomy cost?
The cost varies based on several factors specific to your case, including whether one or both breasts are removed, whether breast reconstruction is performed at the same time, the type of implants or tissue used if reconstruction is included, the length of your hospital stay, and the class of room you choose. Requesting a written estimate directly from the hospital is the most reliable way to understand what your total costs will be.
How long is the recovery time after a mastectomy?
Most people are ready to leave the hospital within one to three days after surgery, and the initial wound healing takes around four to six weeks. Full recovery, especially if reconstruction was performed, can take several months. Your surgeon will give you a personal timeline based on what was done during your operation.
What warning signs should I watch for after a mastectomy?
Contact your doctor promptly if you notice increasing redness, warmth, or swelling around the wound, a fever, unusual fluid or discharge from the surgical site, or sudden chest pain or shortness of breath. Some discomfort and mild swelling in the days following surgery is expected, but these specific signs can indicate infection or another complication that needs prompt attention. It helps to have the contact number of your surgical team easily accessible during your recovery.
This page is general information, not a substitute for medical advice. Every case is different. Your doctor decides what is right for you.
