Modified Radical Mastectomy — Procedure Guide, Recovery & Risks | MyMedicPlus

Modified radical mastectomy (MRM) removes the entire breast, nipple, and overlying skin along with axillary lymph nodes at levels I and II, while preserving the pectoralis major muscle to maintain arm and shoulder function.

Indicated for locally advanced or large breast cancers, node-positive disease, inflammatory breast cancer following neoadjuvant chemotherapy, recurrence after prior lumpectomy, and patients declining breast-conserving surgery.

An elliptical skin incision removes the breast mound, nipple-areolar complex, and overlying skin. Axillary lymph node dissection removes level I–II nodes. The pectoralis major is preserved. Drains are placed and incision closed.

Drains remain for 1–2 weeks until output drops below 30 mL per day. Shoulder physiotherapy begins at 1 week to prevent stiffness. Adjuvant chemotherapy or radiotherapy starts after 4–6 weeks of wound healing.

Lymphoedema affects 15–25% with full axillary dissection. Other risks include seroma, wound infection, shoulder stiffness, intercostobrachial nerve numbness across the inner upper arm, and chest wall skin breakdown.

MRM provides excellent local control with under 5% local recurrence for appropriately staged disease. Five-year survival for stage II disease is 75–85%. Breast reconstruction achieves high cosmetic satisfaction in most patients.