A plain-English guide to surgery to remove breast tissue for cancer: types, reconstruction options, what it costs abroad, recovery, and safe continuity of care.
Written by our medical board, reviewed quarterlyUpdated 21 January 197010 min read
What a mastectomy is and who it is for
A mastectomy is surgery to remove the breast tissue, performed to treat or, in some high-risk cases, prevent breast cancer. It is recommended when the cancer is too large or widespread for breast-conserving surgery (lumpectomy), when there are multiple tumours, after certain genetic findings, or by patient choice. It is often accompanied by surgery to check or remove lymph nodes in the armpit to assess whether the cancer has spread, which guides further treatment.
The decision between mastectomy and breast-conserving surgery, and whether to have reconstruction, is made with a breast surgeon and the wider multidisciplinary team based on the cancer, your anatomy and your wishes. It is a major operation with significant physical and emotional dimensions, so unhurried counselling matters. Because it is a defined surgical event, it is among the treatments patients consider travelling for, often combined with reconstruction.
Even so, the surrounding plan — diagnosis, any treatment before or after surgery, and long-term follow-up — generally belongs with the home team. A reputable centre will want your full work-up before agreeing to operate and will plan the after-care, not just the surgery.
Types of mastectomy and reconstruction options
There are several types of mastectomy. A total (simple) mastectomy removes the whole breast; a modified radical mastectomy also removes armpit lymph nodes; and skin-sparing or nipple-sparing mastectomies preserve the skin envelope, and sometimes the nipple, to improve the cosmetic result when reconstruction is planned and it is oncologically safe. Which is appropriate depends on the cancer and is a surgical judgement, not a preference to be assumed.
Reconstruction can be done at the same time as the mastectomy (immediate) or later (delayed), and uses either implants or the patient's own tissue (flap reconstruction), each with different trade-offs in recovery, durability and appearance. Some patients choose not to have reconstruction. Reconstruction adds significantly to the complexity, length and recovery of the operation.
Because mastectomy with reconstruction blends cancer surgery and plastic surgery, the choice of approach should balance oncological safety first and cosmetic outcome second. A trustworthy centre presents the realistic options and trade-offs rather than steering you toward the most elaborate procedure.
What is included and what it costs
A mastectomy quote should cover the pre-operative work-up, the surgery, surgeon and anaesthetist fees, hospital stay, pathology of the removed tissue and any lymph nodes (essential for planning further treatment), and post-operative care. If reconstruction is planned, the quote should clearly itemise the reconstruction method, any implants, and the additional theatre and recovery time, which can be substantial.
As a broad orientation only, a mastectomy without reconstruction at an accredited international centre may fall in the mid-thousands of euros, while mastectomy combined with reconstruction — particularly flap-based reconstruction — can be considerably more. Treat any single figure cautiously and insist on a quote tied to your specific operation, including whether reconstruction is immediate or delayed.
Ask how the pathology result feeds into your plan, since it often determines whether chemotherapy, radiotherapy or hormone therapy is recommended, and whether that follow-on treatment is included or is to be arranged at home.
Choosing a surgeon and hospital
For mastectomy, look for a breast surgeon with high volume in breast cancer surgery and, where reconstruction is planned, a reconstructive or plastic surgeon experienced in working alongside them. Look for hospital accreditation such as JCI, board certification in the relevant specialties, and a centre with a breast multidisciplinary team, on-site pathology and the imaging that breast cancer care requires.
Ask how many mastectomies and reconstructions the team performs each year, their complication rates, and how the oncological and reconstructive parts are coordinated. Where nipple- or skin-sparing surgery or immediate reconstruction is proposed, confirm it is oncologically appropriate for your cancer, not chosen purely for appearance.
As with all cancer surgery, judge the centre by its handover. It should request your full records before agreeing to operate and commit to sending a detailed operative report and pathology to your home team, so any further treatment and long-term follow-up can proceed without delay.
Recovery, timeline and fitness to travel
Recovery depends on the extent of surgery and whether reconstruction is done. A straightforward mastectomy may involve a short hospital stay and several weeks before returning to normal activity, while mastectomy with flap reconstruction is a bigger operation with a longer hospital stay and a recovery measured in weeks to a couple of months. Drains are often in place for a period, and shoulder and arm exercises are usually needed to restore movement.
The travel-specific issue is fitness to fly: surgery raises the risk of blood clots, and longer or reconstructive operations extend the time before flying is safe, so wait for your surgeon's clearance. Plan a stay long enough to cover surgery, initial recovery, drain and suture removal, and the pathology result, which often guides the next phase of treatment.
There is also an emotional recovery, and access to support and physiotherapy matters. Leave with a full operative report, pathology, wound-care and exercise instructions, and a clear plan for ongoing care with your home team.
Risks and what if something goes wrong
Mastectomy carries the general risks of major surgery — bleeding, infection, anaesthetic complications and blood clots — plus specific ones such as seroma (fluid collection), changes in shoulder and arm movement, numbness, and, where lymph nodes are removed, a risk of arm swelling (lymphoedema). Reconstruction adds its own risks, including implant problems or, for flap surgery, issues with the transferred tissue. Experienced teams reduce these risks and manage complications better.
The travel-specific risk is what happens if a complication develops after you return home, or if the pathology shows further treatment is needed while the surgical centre is far away. Reconstruction in particular may require follow-up procedures or adjustment, which is harder to manage at a distance. Get a second opinion before committing and confirm how the centre supports patients after discharge.
Keep every document — operative report, pathology, implant details if relevant, and discharge instructions. The pathology is especially important, as it shapes whether you need further treatment; make sure it reaches your home oncologist promptly.
Frequently asked
Can I have breast reconstruction at the same time as my mastectomy?
Often yes — immediate reconstruction is possible when it is oncologically safe and suitable for you. It can also be done later (delayed). Your breast and reconstructive surgeons will advise on the best timing for your case.
What is the difference between the types of mastectomy?
They differ in how much tissue and how many lymph nodes are removed, and whether the skin or nipple is preserved. The right type depends on your cancer and is a surgical judgement, balancing safety and appearance.
How soon can I fly home after a mastectomy?
It depends on the operation. Surgery raises clot risk, and reconstruction lengthens recovery, so you must wait for your surgeon's clearance — often a few weeks, longer after flap reconstruction. Plan your stay around recovery.
How much does a mastectomy cost abroad?
It varies with the type and whether reconstruction is included, from the mid-thousands of euros without reconstruction to considerably more with flap-based reconstruction. Always get a quote tied to your specific operation.
Will I need more treatment after the surgery?
Possibly. The pathology of the removed tissue and lymph nodes often determines whether chemotherapy, radiotherapy or hormone therapy is recommended. Getting that pathology to your home oncologist quickly is important.
What is lymphoedema and how likely is it?
Lymphoedema is swelling of the arm that can occur when armpit lymph nodes are removed or treated. The risk varies with the extent of surgery; your team can advise on prevention and early management.
