Mastectomy
A mastectomy is a surgical procedure that involves the removal of one or both breasts, partially or completely, typically as a treatment for breast cancer. The goal of the surgery is to remove the complete breast tissue along with as much skin as possible along with the cancer lump.
This procedure is the current standard of care for women diagnosed with breast cancer. This procedure can be done either before or after chemotherapy. Most patients with breast cancer depending on the stage of the disease undergo surgery and would also receive radiation along with chemotherapy. The surgery for breast cancer consists of either Mastectomy ( Removal of the entire breast) or Lumpectomy aka Breast Conserving surgery.
Mastectomy would be offered when:
- Large Tumors: If the tumor is too large relative to the breast size to be removed by a lumpectomy.
- Multiple Tumors: If cancer is found in several areas of the breast.
- High Risk of Recurrence: If there is a high genetic or familial risk of cancer recurrence (e.g., BRCA1 or BRCA2 gene mutations).
- Patient’s Choice: Some women opt for a mastectomy even when breast-conserving surgery (lumpectomy) is an option to reduce the risk of recurrence or for peace of mind.
There are several types of mastectomies depending on the extent of cancer and patient-specific factors.
Types of Mastectomy:
- Total (Simple) Mastectomy: The entire breast is removed, including the nipple, areola, and most of the overlying skin. Lymph nodes under the arm and chest muscles are usually left intact.
- Modified Radical Mastectomy: In this procedure, the entire breast is removed, along with the nipple, areola, and some lymph nodes under the arm. However, the chest muscles are usually preserved.
- Skin-Sparing Mastectomy: The breast tissue is removed, but much of the skin over the breast, except for the nipple and areola, is preserved. This approach is often used when immediate breast reconstruction is planned. This happens when the tumor is close the Nipple aerola and hence they can’t be saved.
- Nipple-Sparing Mastectomy: The breast tissue is removed, but the nipple and areola are preserved, along with most of the skin. This technique is used in select cases when breast reconstruction will follow.
Preparing for a mastectomy
Before having a mastectomy, you will have the opportunity to discuss the operation with a specialist surgeon. You can discuss how the procedure might affect you physically and emotionally. You’ll also get practical advice about bras and bra inserts, if you need them.
Your surgeon will discuss the type of mastectomy you’ll have, the possible complications and the option of breast reconstruction. You may need to have chemotherapy or hormone therapy before the operation to reduce the size of any tumours.
Recovery:
- Physical Recovery: Typically, patients stay in the hospital for a day or two following the surgery, though recovery can take several weeks depending on the type of mastectomy and whether reconstruction was done. During the surgery, a tube will be placed under the skin, which will remove all the fluid and blood that may form under the skin to prevent infection. Patients often are discharged with the tube, which would be usually removed during the followup visit.
- Emotional Recovery: A mastectomy can have a significant emotional and psychological impact, as it changes the appearance of the body. Many women seek counselling or join support groups to help navigate these feelings. We at Hyderabad Breast Clinics would help lessen the impact of the procedure by handholding you through your journey in the hospital and during followup.
Breast Reconstruction:
Some women choose to have breast reconstruction immediately after a mastectomy or at a later date (Delayed Reconstruction). This can involve the use of implants(Artificial breast kept under the skin during surgery) or use tissue from other parts of the body (e.g., the abdomen or back) to create a new breast shape.
Risks and Complications:
- Infection is usually very minimal (Diabetics have an higher chance of infection)
- Bleeding
- Pain and discomfort can be very minimal in the first 24 hours. Most of our patients start ambulating within few hours of surgery.
- Lymphedema (swelling caused by lymph node removal) is the result of surgery done in the armpit to clear the cancer disease and as a side effect of this attempt patients can have slow gradual swelling of the arm on the side operated. We at Hyderabad Breast Clinics show you various methods by which this problem can be avoided and if it appears how to comfortably manage it to lead a near normal lifestyle.
