Mastectomy

Mastectomy. It is the medical term for the removal of one or both breasts partially or completely. If only the gland is removed but the skin of the breast, areola, and nipple are preserved, it is called a subcutaneous mastectomy .

Summary

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  • 1 Alternative names
  • 2 Description
  • 3 Reason why the procedure is performed
  • 4 Risks
  • 5 Before the procedure
  • 6 After the procedure
  • 7 Forecast
  • 8 Sources

Alternative names

  • Surgical removal of the breast
  • Subcutaneous mastectomy
  • Total mastectomy
  • Simple mastectomy
  • Modified radical mastectomy

Description

You are given general anesthesia (unconscious and painless). The surgeon will make a cut in the breast.

  • For a subcutaneous mastectomy, the surgeon removes the entire breast but leaves the nipple and areola (the pigmented circle around the nipple) in place.
  • For simple or total mastectomy, the surgeoncuts breast tissue free skin and muscle and removes it . The nipple and areola are also removed. The surgeon can perform a biopsy of nearby lymph nodes to see if the cancer has spread.
  • For a modified radical mastectomy, the surgeon removes all of the breast tissue along with some of the lymph nodes under the arm.
  • For a radical mastectomy, the surgeon removes the overlying skin, all the axillary lymph nodes under the arm, and the pectoral muscles. This surgery is rarely done.
  • The skin is closed with sutures (stitches).

Typically, one or two plastic tubes or drains are left in place in the chest to remove extra fluid from where the breast tissue used to be.

The surgeon may reconstruct the breast (with artificial implants or tissue from the body itself) during the same operation, or a subsequent reconstruction may be chosen.

Reason why the procedure is performed

  • Women who are diagnosed with breast cancer.

If you are diagnosed with breast cancer, talk to your doctor about your options:

  1. A lumpectomy is when only the breast cancer and the tissue around the cancer are removed. Also called breast conservation therapy or partial mastectomy. Part of the breast will be left.
  2. A mastectomy is when all of the breast tissue is removed. This procedure is a better option if the cancer area is too large to remove without deforming the breast.

You and the doctor should consider:

  1. The size of the tumor, where it is located in the breast, if you have more than one tumor in the breast, how much of the breast is affected by the cancer and the size of the breasts.
  2. Your age, family history, general health, and whether you have reached menopause.

Selecting what is best for you can be difficult. Sometimes it is difficult to know if lumpectomy or mastectomy is best. You and the doctors who are treating your breast cancer will make the best decision together.

  • Women at high risk of breast cancer.

Women who are at very high risk for breast cancer may choose to have a prophylactic mastectomy. The doctor may do either a subcutaneous mastectomy or a total mastectomy to reduce the risk of breast cancer. This is called a prophylactic or preventive mastectomy.

You may have a higher risk of developing breast cancer if one or more close relatives have had this type of cancer, especially at an early age. Genetic tests (such as BRCA1 or BRCA2) can also show that you are at high risk.

This surgery should only be done after careful reflection and analysis with your doctor, a genetic counselor, your family, and others. Mastectomy greatly reduces, but does not eliminate, the risk of breast cancer.

Risks

The risks of any surgery are:

  • Blood clots in the legs that can travel to the lungs.
  • Loss of blood.
  • Respiratory problems.
  • Infection, including in the surgical wound, lungs (pneumonia), bladder, or kidney.
  • Heart attack or stroke during surgery.
  • Drug reactions.

Scab, blisters, or skin loss may occur along the edge of the surgical incision.

The risks when performing more invasive surgery, such as radical mastectomy, are:

  • Pain and stiffness in the shoulder. You may also feel tingling where the breast was and under the arm.
  • Swelling of the arm (called lymphedema) on the same side of the removed breast. This swelling is not common, but it can be an ongoing problem.
  • Nerve damage, which can cause numbness in the inside of the arm or weakness in the muscles of the back and chest wall.
  • Damage to the nerves that go to the muscles of the arm, back, and chest wall.

Before the procedure

You will have many blood and imaging tests (such as CT scans, bone scans, and chest x-rays ) after the doctor finds breast cancer. The surgeon will need to know if your cancer has spread to the lymph nodes, liver, lungs, bones, or elsewhere.

Always tell your doctor or nurse if:

  • Could be pregnant.
  • You are taking a drug or herb that you bought without a prescription.

During the week before surgery:

  • Some days before the operation, you may be asked to stop taking aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), vitamin E, clopidogrel (Plavix), warfarin (Coumadin), and any other drugs. that hinders blood clotting.
  • Ask your doctor which drugs you should take even on the day of surgery.

On the day of surgery:

  • Follow the instructions of the doctor or the nursing staff regarding eating or drinking before the intervention.
  • Take the drugs your doctor recommended with a small sip of water.
  • Your doctor or nurse will tell you what time you should arrive at the hospital.

After the procedure

You can stay in the hospital for 1 to 3 days, depending on the type of surgery you have had. If you had a simple mastectomy, you can go home the same day. Most women go home after 1 to 2 days. You can stay longer if you have a breast reconstruction.

Many women leave home with drains still attached to the chest. The doctor later removes them during a visit in his office. You may have pain around the incision site after surgery.

Fluid may accumulate in the mastectomy area after all drains are removed. This is called a seroma. It usually goes away on its own, but it may need to be drained using a needle (aspiration).

Forecast

Most women recover well after mastectomy.

In addition to surgery, you may need other treatments for breast cancer. They can include hormone therapy, radiation therapy, and chemotherapy. They all have their own side effects. Talk to the doctor.

 

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