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Mastectomy is the medical term for the surgical removal of one or both breasts,
partially or completely. It is
usually done to treat breast
cancer; in some cases,
women and some men
believed to be at high risk
of breast cancer have the
operation prophylactically,
that is, to prevent cancer
rather than treat it. It is also
the medical procedure
carried out to remove Modified Radical
Radical Mastectomy.
breast cancer tissue in Mastectomy.
males.
Description
Description
General anesthesia is
administered during
mastectomy, and an ECG
monitor (electrocardiogram)
is connected to the patient
to monitor heart rates. Simple (total)
Blood pressure and vital Partial Mastectomy
Mastectomy.
signs are also monitored
throughout the surgery.
• 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 a total or simple mastectomy, the surgeon cut breast tissue free from
the skin and muscle and removes it. The nipple and the areola are also
removed. The surgeon may do a biopsybiopsy of nearby lymph nodes to see if
the cancer has spread.
• For a modified radical mastectomy, the surgeon removes the entire breast
along with the lining over some of the muscles. Some of the lymph nodes
underneath the arm are also removed.
• For a radical mastectomy, the surgeon removes the overlying skin, all of the
lymph nodes underneath the arm, and the chest muscles. This surgery is not
done unless breast cancer has spread to your chest wall muscles.
• The skin is closed with sutures (stitches) or tape (Steri-Strips).
The drainage tube placed in the breast or under the arm removes blood and lymph
node fluid accumulated during the healing process. Drainage tubes are usually
removed within two weeks, when the drainage is reduced to less than 30 ccs (1 fluid
oz) per day.
Your surgeon may be able to reconstruct the breast (with artificial implants or tissue
from your own body) during the same operation. You may also choose to have
reconstruction later.
Mastectomy generally takes 1 to 3 hours.
Possible effects of mastectomy include:
• wound infection
• hematoma (blood trapped in the wound)
• seroma (clear fluid trapped in the wound)
• lymphedema: temporary to permanent limitations of arm/shoulder movement
(if lymph nodes are removed during the operation)
• numbness in the upper-arm skin
• phantom breast pain
Mastectomy indications
Despite the increased ability to offer breast-conservation techniques to patients
with breast cancer, there exist certain groups who may be better served by
traditional mastectomy procedures including:
• women who have already had radiation therapy to the affected breast
• women with 2 or more areas of cancer in the same breast that are too far
apart to be removed through 1 surgical incision, while keeping the
appearance of the breast satisfactory
• women whose initial lumpectomy along with (one or more) re-excisions has
not completely removed the cancer
• women with certain serious connective tissue diseases such as scleroderma,
which make them especially sensitive to the side effects of radiation therapy
• pregnant women who would require radiation while still pregnant (risking
harm to the fetus)
• women with a tumor larger than 5 cm (2 inches) that doesn't shrink very
much with neoadjuvant chemotherapy
• women with a cancer that is large relative to her breast size
• Women who have tested positive for a deleterious mutation on the BRCA1 or
BRCA2 gene and opt for prophylactic removal of the breasts
• male breast cancer patients
Outlook (Prognosis)
Outlook (Prognosis)
Most women recover well after mastectomy.
In addition to surgery, you may need other treatments for breast cancer. These
treatments may include hormonal therapyhormonal therapy, radiation
therapyradiation therapy, and chemotherapychemotherapy. All have their own side
effects. Talk to your doctor.
Your breast cancer may respond differently to surgery and other treatments for
many reasons. Talk to your doctor about these reasons.
Support and Counseling
A woman who undergoes a mastectomy has to deal with not only the stress of
coping with the cancer but also the anguish of losing her breast. Interacting with
other women who have undergone mastectomies can help in dealing with these
feelings. If a woman lives in the United States, she can locate the Reach to
Recovery program in her area at the Web site of the American Cancer Society,
Support for Survivors and Patients, Reach to Recovery.