Making the Decision to Undergo a Mastectomy
- Mom of two Georgina Hayward discovered a lump in her breast while shaving her armpits and was later diagnosed with aggressive grade-three breast cancer in November 2025, at 30 years old.
- After undergoing a nipple-sparing mastectomy earlier this year, she is now preparing for reconstructive surgery and urging women to watch for body changes and seek medical care quickly.
- Mastectomy is the removal of the entire breast during surgery. There are a number of factors to weigh when considering a mastectomy, chief among them is whether breast-conserving surgery (or lumpectomy) is possible. Your doctor will look at the size and features of your tumor as well as your family history in order to make a recommendation.
- “Breast reconstruction is about restoring both a woman’s form and her sense of self,” explains Dr. Andrea Pusic, Chief of Plastic and Reconstructive Surgery at Brigham and Women’s Hospital. It’s a deeply personal decision, and today’s surgical options can create breasts that look natural and real.
Hayward received a grade-three breast cancer diagnosis in November 2025 and underwent a nipple sparing mastectomy for “peace of mind” on January 6, 2026. Her cancer was classified as a grade three, which Susan G. Komen describes as, “the tumor cells look very abnormal and are fast-growing (poorly-differentiated).”
Read More“See what they say and they will refer you if they think it’s needed and if you’re still not sure, push for your referral to put your mind at ease. Go straight away if you notice any changes because it’s better to know than to be in a worse outcome.”

Looking back on what led to her diagnosis, she said, “Where the lump was I was having a tingly active feeling in that area and it was a bit itchy. I also had tiredness which I blamed on being a mom.
“I have a two-year-old little girl and I was getting up with her quite a few times in the night so I didn’t think anything of it. I’d stopped breastfeeding six months before I found the lump so I was thinking maybe it’s just that and things have settled down and something’s popped up to do with the breastfeeding.”
After visiting her doctor, Hayward—whose mother previously battled breast cancer—underwent an ultrasound and a biopsy, which ultimately confirmed her diagnosis.
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As per Kennedy News & Media, Haywood learned she had an invasive cancer that began in the milk duct, and chose to get the cancer surgically removed.
“I thought in my head that [the mastectomy] was better because I’ve heard from other people that if you just have the lump removed that sometimes you don’t get clear margins,” she explained.
“I thought for peace of mind I would have a mastectomy. I know with having [just] the lump off it would always be in the back of my mind if all the cancer has been taken away.”
Hayward said waking up after her mastectomy was frightening, but she was relieved with the outcome and noted that losing a breast can be especially difficult both emotionally and physically for a young woman.
She explained further, “I’ve had a breast expander put in at the minute while I’m waiting for my other results to come back, depending on what treatment I need.
“And then I can have my permanent implants put in which I’m having on both sides so my breasts match. That will happen in six months to a year’s time depending on what treatment I need next.”
Understanding Mastectomy & Breast Reconstruction
Though Hayward chose to undergo a mastectomy, Dr. Ann Partridge, an oncologist at Dana-Farber Cancer Institute, says there are a number of factors to weigh when considering a mastectomy, chief among them is whether breast-conserving surgery (or lumpectomy) is possible.
Your doctor will look at the size and features of your tumor as well as your family history in order to make a recommendation.
“When I talk to a woman who comes to me and she has breast cancer, I evaluate what the standard options for treatment for her are, which typically include cutting out the cancer– which is either a lumpectomy if you can get it all with just a little scooping around of the area that’s abnormal or a mastectomy for some women meaning taking the full breast because sometimes these lesions can be very extensive in the breast,” Dr. Partridge explains.
If you’ve had a mastectomy, breast reconstruction is one of the major issues to consider. There are several options available.
The reconstruction process can happen at the time of the surgery to remove the breast, or later on in the case of implants. Some women opt for no reconstruction, but decide later on that they want reconstruction to restore a sense of self, or simply get back to the way they used to look.
WATCH: Breast Reconstruction: Regaining Your Sense of Self
“Breast reconstruction is about restoring both a woman’s form and her sense of self,” explains Dr. Andrea Pusic, Chief of Plastic and Reconstructive Surgery at Brigham and Women’s Hospital. It’s a deeply personal decision, and today’s surgical options can create breasts that look natural and real.
Immediate reconstruction can produce better results than delayed reconstruction, resulting in fewer surgeries. However, it may require a more extended initial hospitalization and recovery time. This long surgery may also have a higher risk of complications, such as infections, than two separate surgeries.
It may be worth noting that “Delayed reconstruction has fewer complications than immediate reconstruction,” Dr. Terry Myckatyn, a plastic surgeon specializing in breast reconstruction, told SurvivorNet.
When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). During reconstruction, one can also take one’s own tissue (usually from the belly area) and transfer it to the breast area.
After breast cancer surgery, women diagnosed with early-stage breast cancer may also need chemotherapy, radiation, or hormone therapy.
Dr. Myckatyn, a breast reconstruction specialist at Washington University in St. Louis, emphasizes that the process is collaborative: “It’s a shared decision-making process between the patient and the physician. The patient needs to advocate for herself and make her goals clear.
“The physician needs to provide clear, logical, evidence-based explanations for their recommendations.”
WATCH: How some women may keep their breast size and shape in cancer surgery
Plastic surgeons typically reconstruct breasts using either implants or tissue taken from another part of the body—such as the back, abdomen, or inner thigh. This tissue-based approach, known as a flap procedure, often produces breasts that look and feel more natural than implants and can change with your body over time, for example, with weight gain or loss.
However, flap procedures involve more extensive surgery, longer recovery, and additional scarring—both at the breast and at the donor site. They may also weaken muscles where tissue is taken, and not all patients are candidates. Women who smoke or have certain health conditions, such as poorly controlled diabetes, circulation problems, or connective tissue disorders, may not be eligible.
Implant-based reconstruction usually requires fewer surgeries, smaller incisions, and less scarring, allowing for a quicker return to daily life. The trade-off is that implants don’t adapt to body changes, which can make them look less natural over time. Implants also carry risks of leakage or rupture, which would require replacement.
Every surgical option comes with risks. Understanding those risks—and weighing them against your personal goals—is essential before making a decision.
Another aspect of breast cancer surgery involves the possibility of sparing the nipple.
WATCH: Understanding Nipple-Sparing Mastectomies
During a nipple-sparing mastectomy, doctors use special techniques to remove a woman’s breast, leaving the skin and the nipple intact. The idea is to maintain, as close as possible anyway, the natural look of the breast. After a mastectomy, a plastic surgeon will use either an implant or the woman’s own tissue to recreate the breast. When a woman’s own tissue is used, doctors typically take it from fat in the patient’s lower abdomen.
“Nipple-sparing mastectomy, or nipple-preserving mastectomy, differentiates itself from the traditional mastectomy where the nipple was not saved,” Dr. Irene Wapnir, a surgical oncologist and breast surgeon at Stanford University Medical Center, explains to SurvivorNet.
“It’s the ideal procedure for those women who choose to have prophylactic mastectomy who don’t yet have breast cancer, who will choose that route because they have a strong family history of breast cancer, or if they’ve been tested and are a carrier of a mutation, a gene mutation, that predisposes them to a much higher risk of developing breast cancer,” Dr. Wapnir explains.
Why Self-Advocacy in Healthcare Can Be Life-Saving
When patients actively advocate for their health, it can lead to earlier diagnoses, broader treatment options, and ultimately better outcomes—especially when initial symptoms are overlooked or dismissed.
Part of this advocacy means not settling for a single medical opinion. Persistence matters: revisiting your doctor, pushing for answers, and seeking additional perspectives from other healthcare providers can be crucial steps in the journey.
WATCH: The value of getting a second opinion
Dr. Steven Rosenberg, Chief of Surgery at the National Cancer Institute, underscored this point in a conversation with SurvivorNet:
“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care. Because finding a doctor who is up to date with the latest information is important,” Dr. Rosenberg said.
His words are a powerful reminder that having the right medical team can make all the difference—and that begins with being your own strongest advocate.
Getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon who is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.
Other reasons to get a second opinion include:
- To see a doctor who has more experience treating your type of cancer
- You have a rare type of cancer
- There are several ways to treat your cancer
- You feel like your doctor isn’t listening to you, or isn’t giving you sound advice
- You have trouble understanding your doctor
- You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
- Your insurance company wants you to get another medical opinion
- Your cancer isn’t improving on your current treatment
Some health insurance companies will cover the cost of a second opinion. Still, it’s a good idea to find out if yours does before you visit a new doctor, as some insurance companies have stipulations on the extent of coverage they will provide.
Keep in mind that you don’t need to stop at a second opinion. Provided that you have the time and financial resources, you may want to consider getting a third or a fourth opinion. Just don’t get so many opinions that your treatment options overwhelm you.
With each new doctor you visit, bring a copy of your:
- Pathology report from your biopsy or surgery
- Surgical report
- Imaging tests
- The treatment plan that your current doctor recommended
Helpful Information About Breast Cancer Screening
The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives. For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.
Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.
RELATED: Mammograms Are Still the Best Tool for Detecting Breast Cancer
Experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.
RELATED: 3D Mammography Detects 34% More Breast Cancers Than Traditional Mammography
Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:
- Older age
- Having a gene mutation such as the BRCA1 or BRCA2
- Added exposure to estrogen
- Having children after the age of 30
- Exposure to radiation early in life
- Family history of the disease
Different types of genetic testing can help people with a family history of cancer better ascertain their cancer risks. Your doctor will discuss your family history of cancer with you in the context of your type of tumor and your age at diagnosis. Hereditary genetic testing is usually done with a blood or saliva test.
WATCH: Understanding genetic testing for breast cancer.
About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.
“We encourage only those with a family history to get [genetic testing],” Dr. Ginsburg previously told SurvivorNet. “I would say that if you have anyone in your family diagnosed with a rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome.
The second test involves the genetic sequencing of your tumor if you’ve been diagnosed with cancer by this point. These genetic changes can be inherited, but most arise during a person’s lifetime. This process usually involves examining a biopsy or surgical specimen of your tumor. This testing can lead to decisions on drugs that might work against your cancer.
“Digital mammography, it turns out, significantly improves the quality of the mammogram… It’s 3D or tomosynthesis mammography,” Dr. Connie Lehman, a diagnostic radiologist who specializes in breast cancer at Massachusetts General Hospital in Boston., explains.
“This allows us to find more cancers and significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.
Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance.
Contributing: SurvivorNet Staff
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