Q. I just found out I have to have a mastectomy. It sounds awful; I’m scared. Help!

A. Being told you need a mastectomy is shocking, because all you can think is, “They’re going to cut off my breast!” Yes, it sounds brutal; but if you’re worried about your physical appearance, you can choose to have reconstructive surgery or implants.

Emotionally, it takes some time to internalize that you’re going to lose your breast; but don’t worry, you’ll get there. Millions of women have had this operation and gotten through it just fine.

Q. I’m kind of upset that the surgery isn’t for another 4 weeks. Isn’t that dangerous? Won’t the cancer keep growing?

A. Especially if you’re having reconstruction, it takes time to schedule two surgeons (one to take off your breast, another to rebuild a new one), plus find an open operating room. So yes, it can be awhile between diagnosis, your decision to have a mastectomy, and the actual operation.

But don’t fret; cancer, unless it’s inflammatory breast cancer, is relatively slow-growing. A typical tumor grows for 8 years before it’s large enough to be felt or detected on a mammogram. An extra few weeks shouldn’t make any difference.

Q. So, what exactly is involved in the surgery? I listened to what the surgeon said, but it was upsetting and he kind of lost me along the way.

The simplest type of mastectomy, which some women choose when they’re diagnosed with DCIS (non-invasive cancer), removes just your breast skin and tissue, without any of your chest wall or muscles, and without any underarm lymph nodes. It takes one surgeon up to 2 hours or so, and is done under general anesthesia.

A modified radical mastectomy without reconstruction, which takes 2 to 3 hours, is also performed by one surgeon. This operation removes your breast tissue, as well as lymph nodes from under the arm, so the pathologist can determine if your cancer has spread outside the breast.

A modified radical mastectomy with reconstruction can take up to 7 or 8 hours, possibly more, depending on the complexity of the reconstruction. Typically, a reconstruction that uses tissue from another part of your body (as opposed to an implant) takes longer, as the two surgeons working on you (one to remove your breast, and a plastic surgeon to rebuild it) will be working on two different sites: your breast, and the place from which the healthy tissue is harvested.

As with any serious surgery, you’ll be admitted to the hospital, asked to change into a gown, and be assigned a bed in the waiting area. You may be asked to “X” or sign the affected breast with a marker; a nurse may also draw on the breast to show the surgeon where to start the incision. You’ll be prepped with a drug to relax you before you go to the operating room.

Once in the operating room, you’ll be anesthetized, and the operation performed. All of your breast tissue will be removed; your breast skin may or may not be removed, as well, depending on whether you’re having an immediate reconstruction. The surgeon will either continue on and perform the reconstruction; or, if you’re not having an immediate reconstruction, (s)he will insert some drainage tubes into the wound, close up the incision, and apply a loose bandage.