Mastectomy

Surgery is recommended when a mammary mass is detected because:

• It is the only way to obtain a definitive diagnosis — the removed tissue is always sent for histopathology (microscopic analysis)
• Early, complete removal gives the best chance of preventing local recurrence and spread to lymph nodes or lungs
• In cats, even small tumors can be aggressive; waiting for a mass to grow is not advisable
• Concurrent spay at the time of mastectomy removes the hormonal stimulus that drives mammary tumor growth in dogs

Chest X-rays are taken before surgery to screen for lung metastasis; regional lymph nodes may also be sampled to help stage the disease.

The surgery is performed under general anesthesia with full monitoring. The approach depends on how many glands are involved:

• Simple (lumpectomy): the mass alone is removed with a small margin — reserved for small, discrete, superficial tumors strongly suspected to be benign
• Regional mastectomy: the affected gland(s) and the one or two glands sharing a lymphatic field are removed together as one specimen
• Radical (unilateral or bilateral) mastectomy: the entire mammary chain on one or both sides is removed when multiple glands are affected or tumor biology warrants wide excision

All specimens are submitted for histopathology. Lymph nodes in the surgical field are typically removed and submitted separately so the pathologist can assess spread. The wound is closed in layers and the patient is kept warm and closely monitored through recovery.

Before mastectomy, the team performs:

• Pre-anesthetic bloodwork to assess organ function and clotting status
• Chest X-rays (two views) to look for lung nodules that would indicate metastasis
• Abdominal ultrasound when indicated to evaluate internal lymph nodes

Withhold food the evening before surgery; water is generally permitted until a few hours prior. Discuss any medications or supplements with the care team, as some affect anesthesia or clotting. Planning a confined, comfortable recovery space at home before the appointment makes the return home smoother.

Mastectomy involves a longer incision than a simple lumpectomy, but most patients go home the same or following day and recover well. Key aftercare points:

• An Elizabethan collar (e-collar) must be worn consistently until sutures are removed at 10 to 14 days
• Activity restriction — leash walks only, no jumping — for two weeks
• Daily inspection of the incision line for swelling, discharge, or opening
• Pain medication for the first several days; most pets are comfortable and eating normally within 48 hours
• A pathology report review appointment at suture removal — the report guides all future monitoring and, if indicated, referral for adjuvant therapy

Mastectomy is generally well tolerated. Potential complications include wound seroma (fluid pocket under the incision), dehiscence (wound opening), infection, and — with radical mastectomy — temporary swelling of the limb closest to the surgery. These are uncommon and manageable. The bigger long-term risks are tumor recurrence and metastasis, which depend on tumor grade, type, and whether margins were clean — all reported by the pathologist. Cats with malignant mammary tumors often benefit from oncology consultation for chemotherapy planning after surgery. The team will explain all findings and next steps at the post-operative recheck.