Recent advances in breast cancer treatment have broadened the range of surgical options available to patients, allowing women to make choices that best suit their personal needs and preferences. While mastectomy—the removal of the entire breast—was once considered the standard procedure for breast cancer, many patients today opt for lumpectomy, which removes only the tumor and preserves the breast. This approach, typically followed by radiation therapy, is now a common solution for early-stage breast cancer cases and offers survival rates similar to those of mastectomy.
In Wisconsin, between 2013 and 2022, over 49,000 women were diagnosed with breast cancer. Medical professionals now emphasize that the goal is to save the breast whenever possible, unless the cancer has spread too widely or genetic risks require more proactive procedures. Some patients, particularly those who carry mutations like BRCA or ATM genes, may choose preventative mastectomy to reduce their lifetime risk. Others may decide on mastectomy for personal reasons, such as avoiding radiation or seeking peace of mind.
After mastectomy, women face another important decision: whether to have breast reconstruction or opt for a procedure known as aesthetic flat closure. Breast reconstruction involves rebuilding the breast mound with implants or using tissue from other parts of the body, and is often viewed as a way to restore body image and femininity. In contrast, aesthetic flat closure—commonly called “going flat”—means the skin is closed over the chest wall to create a smooth, flat contour. Many women are now choosing to go flat, motivated by faster recovery, fewer surgeries, and avoidance of implant risks, such as rare lymphomas associated with certain implants.
Studies show that nearly three-quarters of women who chose flat closure after mastectomy said it was their preferred first choice. National trends indicate a steady increase in women selecting this option, backed by growing patient awareness and advocacy. Specialists stress that all patients deserve unbiased information and balanced counseling about their options, so they can make decisions based on what matters most to them. There is no single correct choice after mastectomy; both reconstruction and flat closure are valid approaches, and patients should feel supported regardless of their decision.
Quality of life after treatment has become increasingly important as survivorship increases. Some women find reconstruction empowering, while others prefer the simplicity and freedom of going flat. Experts urge healthcare providers to respect every patient’s informed choice, provide careful guidance, and ensure that surgical procedures are carried out with the same care and expertise for all options. True progress in breast cancer care comes from honoring the patient’s decision and supporting them as they move forward.
