Let me take you back in time to see how mastectomy surgery has changed. The original method was known as a Halsted radical mastectomy. Created by Dr. William Halsted at Johns Hopkins a century ago, the surgery involved the removal of the breast, chest muscles, and all the lymph nodes under the arm. Back then, it was common to do a skin graft from the patient's back to cover the chest wound.

Today, mastectomy surgery is quite different. Medical advances that I think even Dr. Halsted would be proud to see have brought us the skin-sparing mastectomy with sentinel node biopsy. An incision is made around the edge of the areola and the breast is hollowed out, allowing this space to be filled with an implant or fatty tissue from elsewhere on the body, commonly tummy fat. The procedure leaves a more natural-looking breast; keeping the outer skin allows restoration of the natural contour of the breast. If no cancer is found in the sentinel node, no additional nodes need to be removed from the armpit area.

Some women worry that skin-sparing mastectomy results in higher recurrence rates. The studies show that this isn't really an issue. Remember that the skin is another organ and not breast tissue per se.

After the surgery, a woman can choose to have nipple reconstruction and areola tattooing as well, providing a pretty amazing cosmetic result. Plastic surgeons and surgical oncologists who are expert at doing these procedures work as a team and take pride in ensuring symmetry and good cosmetic results.