About Mastectomy
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What is mastectomy?
Mastectomy is the surgical removal of a breast. Mastectomy is used as a treatment for breast cancer. There are different types of mastectomy; The size and type of the tumor, the stage of the cancer, and the amount of lymph nodes to be removed are the factors that determine which type of mastectomy is appropriate for a patient. It also depends on the age and health of a patient.
What are the different types of mastectomy?
The different types of mastectomy are as follows:
- Simple/Total Mastectomy
In Simple/Total Mastectomy, the whole breast is removed, but the lymph nodes and the tissue surrounding it is not removed.
- Modified Radical Mastectomy
In Modified Radical Mastectomy, the whole breast, along with the lymph nodes in the armpits and the tissues lining the chest muscles are removed. The muscles remain in place. This is the most widely used method of mastectomy.
- Radical Mastectomy
In Radical Mastectomy, the breast, lymph nodes, muscles beneath the breast and the surrounding tissue of fat are removed. This is a rarely performed method and is only used for extensive tumors and if the cancer has spread to the chest wall.
- Skin-Sparing Mastectomy
In Skin-Sparing Mastectomy, a small incision is made around the areola. The tumor is removed through the incision. The skin is preserved and scarring is insignificant in this procedure. During this procedure, reconstruction is also performed by a plastic surgeon.
- Subcutaneous Mastectomy
In Subcutaneous Mastectomy, the tumor along with the breast tissue is removed. However, the nipple and skin are not removed. This procedure ensures an easy reconstruction surgery, however several cancer cells may not be removed.
- Partial Mastectomy
In Partial Mastectomy, the amount of breast tissue and the skin that is removed are large. Lymph nodes and the tissues lining the chest muscles beneath the tumor are also removed. This procedure is appropriate for tumors that are in stage 1 and 2.
- Lumpectomy
In Lumpectomy, the tumor and the tissue surrounding it is removed. Some lymph nodes are also removed.
How to prepare for a mastectomy?
- Before a mastectomy, the doctor examines the patient and performs some tests. These include:
- Physical examination
- X-ray
- Blood test
- Urinalysis
- Electrocardiogram
- The patient should inform the doctor about
- Health and medical conditions such as pregnancy or heart disease
- Any medication the patient may be taking
- The doctor will inform the patient about the surgical procedure and what to expect from it.
- The doctor will decide which type of anesthesia should be given to the patient after determining the extensiveness of the surgery.
- The doctor will discuss details about breast reconstruction.
Duration of procedure/surgery : 1 to 3 hours
Days admitted : 1 to 7 days
Anesthesia : General anesthesia
Recovery : - The patient is taken to a recovery room to be monitored after the surgery. After the blood pressure, pulse and breathing become stable, the patient is shifted outside the recovery room.
- Pain medication may be given to reduce severe pain.
- The patient needs to stay in the hospital for some days depending on the method of mastectomy and reconstruction.
- The result after the mastectomy is given in about one week.
Risks : The potential risks of mastectomy are:
- Bleeding
- Infection
- Chronic pain known as post-mastectomy pain syndrome
- Arm swelling
- Hard scar tissue
- Shoulder pain
- Stiffness
- Numbness in the armpit
- Hematoma
- Psychological effects of losing a breast
After care : Most patients recover well after a mastectomy. Their recovery is both physical as well as emotional. If required, the doctor will schedule follow-up visits for further treatment. The patient may be referred to the following doctors:
- Radiation oncologist for radiation treatments
- Medical oncologist for other treatments like hormone therapy
- Plastic surgeon for breast reconstruction
- Counselor or support group for dealing with breast cancer
The doctor should be informed if the following symptoms occur:
- Fever
- Increasing pain
- Infection, redness, swelling, and bleeding at the incision area
- Stitches on the wound need repair
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