Mastectomy

Mastectomy is a surgical procedure to remove the entire breast containing cancer. The objective of the medical procedure is to remove cancerous tissues from the breast area. Alternately, some people prefer having a lumpectomy, a procedure used for removing only the cancerous cells by conserving a major portion of the breast.

Many women choose Mastectomy over Lupectomy for personal reasons. However, the possibility of a second attack of cancer is treated with a double mastectomy, in which both the breasts are removed.

There are several types of Masctemtomy, but the right option for you depends upon several factors like your general health, age, the tumour size, your menopause status, the tumour’s hormone receptor status, the stage of tumour (if it has spread), grade of the tumour and whether lymph nodes are involved.

The suitable candidates for Mastectomy are women who have cancer in their breasts and want to remove all diseases tissues and lymph nodes to prevent it from spreading to other areas of the body. Nonetheless, most women prefer breast-conserving surgeries over a Masctectomy if it’s a reasonable option. If the doctor still feels that a Mastectomy is the best choice, he goes for it. For instance, Mastectomy is highly recommended for women who are:

• Unable to have a radiation therapy
• Already had a breast conserving surgery, but the cancerous tissues were not completely removed
• Had very large tumour bigger to the breast size
• Had two or more tumours in the same breast that can only be removed with a Mastectomy
• Had inflammatory breast cancer, etc.

The five different types of Mastectomy are discussed below:

• Simple or Total Mastectomy- This surgical procedure of Mastectomy removes the entire breast, but no muscles are removed from underneath the breast. In some cases, lymph nodes are removed if they happen to be present in the breast tissues.
• Modified Radical Mastectomy- In this procedure, the entire breast is removed along with dissection of the axillary lymph nodes in which level I and level II of lymph nodes are eliminated. However, no muscles are removed from under the breast.
• Partial Mastectomy- Lupectomy is, sometimes, used as a technical term for Partial Mastectomy that removes only cancerous portion of the breast along with some surrounding healthy normal tissues. However, more tissues are eliminated in a partial a mastectomy over a Lupectomy.
• Radical Mastectomy- When breast cancer spreads to the chest muscles, Radical Mastectomy is performed. The procedure helps to remove the whole breast with maximum effectiveness.
• Nipple-sparing Mastectomy- During the surgery, all the breast tissues are removed, only leaving the nipples.

Many women want to have a breast re-construction procedure after a mastectomy. Although, it is feasible for doctors to perform breast re-construction to restore the breast’s appearance, the possibilities vary from patient to patient. Sometimes, a reconstruction procedure is done immediately after a mastectomy, while in some cases it is performed later.

Before Mastectomy surgery, you need to undergo a few preparations as advised by your doctor.

• Talk to your doctor regarding any doubts related to a mastectomy surgery like how the procedure is performed, the risks involved and whether you can have a reconstruction.
• You will have to go through a thorough physical examination to ensure no complications arise during and after the surgery. Talk to your anaesthesiologist regarding the anaesthesia plan.
• You are given advices on the restrictions of a breast cancer surgery. Tell your doctor about the supplements, vitamins and medicines you are taking, based upon which you may be asked to stop certain medication before the surgery.
• You are advised to stop taking blood thinners and aspirins that generally interfere with the surgery.
• You are asked to stop eating or drinking 8-12 hours before the surgery.
• Bring some essentials like loose clothes, robes, toothbrush and paste and some books to help you spend time.

This is how a mastectomy is performed:

• You are given general anaesthesia in order to help you sleep throughout the procedure
• A large incision is made to remove the diseased breast tissues.
• The open cuts are then stitched and a temporary tube is attached to allow fluid from the wound area to drain out.
• The removed tissues are then sent to the pathology lab where they are examined under a microscope for cancerous cells. If cancer cells are diagnosed in the rim of the tissues, a mastectomy is performed. The surgical procedure removes the entire breast.
• Once done, radiation therapy is used to destroy any remaining cancer cells in the area.

The hospital recovery time of mastectomy is 1-2 nights after which the woman is discharged. In some cases, some women are kept under observation in a 23-hour unit after which she is allowed to go home. The overall recovery of mastectomy depends upon the type of surgery performed. Usually, mastectomy patients can return to work after 4 weeks of the surgery.

While at home, you should know how to take care of the surgery site. Know about how to detect any infections at the incision site, how to shower and bath, how to do arm exercises to prevent stiffness, when to start wearing a bra, what to eat and what not to, what to expect regarding the numbness and sensations in the arm and breast, when to have a follow-up appointment with the doctor.