Halsted’s radical mastectomy

Patey’s mastectomy

Total or simple mastectomy

Skin-sparing mastectomy

Started in…



Around 1977



Breast tissue, Pectoralis major and minor, all axillary tissue removed

Breast tissue, Pectoralis minorand axillary nodes removed

Breast tissue and involved skin removed; with or without axillary surgery

Breast tissue removed, but skin envelope preserved (nipple may also be preserved)


Extremely rare cases nowadays, e.g. tumour spread to chest wall

More invasive tumours

Most common type of mastectomy

Small tumours only

Essential risks and complications

Extensive scars, lymphoedema, reduced shoulder mobility

Lymphoedema, seromas, haematomas

Seromas, haematomas, flap necrosis

Recurrence, nipple ischaemia or malposition

Important patient outcomes

Life changing, with significant decrease in quality of life

Significant risk of lymphoedema which may markedly reduce quality of life

Negative effect on esteem, sexual attraction, increased rates of depression and anxiety

Generally pleasing and satisfactory cosmetic outcome for the patient