A mastectomy is a breast removal surgery that is usually performed to treat or prevent breast cancer. If your doctor has recommended a mastectomy for your treatment, you probably have a lot of questions about it. In this article, we will discuss the different types, applications, risks and benefits.
Types of mastectomy
1. Total or complete mastectomy
A complete mastectomy is also called a simple mastectomy. In this procedure, the surgeon removes all of the breast tissue, including the nipple, the areola, and the skin. Most of the time, sentinel lymph nodes are removed at the same time to check for more information about the cancer. A complete mastectomy may be a good option for the early stages when the cancer has not yet reached the axillary lymph nodes.
۲. Radically modified mastectomy
A modified radical mastectomy determines whether the cancer has spread to the lymph nodes under the arm. This method involves removing the following:
- The entire breast tissue including the nipple, areola and skin;
- Some axillary lymph nodes;
- In some cases, cover the chest muscle.
3. Radical mastectomy
Radical mastectomy is a complex surgery that involves removing the following:
- The entire breast tissue including the nipple, areola and skin;
- All axillary lymph nodes;
- Major and minor pectoral muscles.
Radical mastectomy was once one of the standard methods of treating breast cancer, but now, due to improved imaging and radiation techniques, surgeons are likely to recommend a modified radical mastectomy.
4. Partial or incomplete mastectomy
In this procedure, the surgeon removes the cancerous area with some healthy surrounding tissue. This method may be used when there is only a small area of cancerous tissue.
5. Skin protective mastectomy
Protective mastectomy involves the removal of breast tissue, nipples, and the area around the areola, but most of the skin remains intact. This surgical procedure is used when breast reconstruction is performed simultaneously. This method is not used when the primary tumor is large or the cancer is not seen near the surface of the skin.
6. Mastectomy preserves the nipple
In nipple preservation mastectomy, all breast tissue is removed, but the areola and nipple are preserved. This method is a good choice when breast reconstruction begins immediately. This method is only used for early-stage breast cancer that does not involve the skin or nipple.
7. Bilateral mastectomy
In bilateral mastectomy, the tissue of both breasts is removed. Bilateral mastectomy is sometimes performed as a (risk-reducing) surgery for women who are at high risk for breast cancer. Most of these surgeries are simple mastectomies, but some may not remove the nipple.
In other situations, a bilateral mastectomy is performed as part of a women’s breast cancer treatment program. This is done after careful examination and talking to the cancer care team.
When is a mastectomy performed?
In response to when a mastectomy is performed, it should be said that it is usually recommended in these cases:
- When a person cannot be treated with breast protection surgery (lumpectomy);
- The person is unable to perform radiation therapy;
- A person has inflammatory breast cancer;
- Experience breast radiation therapy in the past;
- The presence of two or more cancerous areas in different quarters of a breast that are not close enough;
- Tumor larger than 5 cm or a tumor larger than breast size;
- Having a genetic factor such as a BRCA mutation.
How to prepare for a mastectomy?
When your surgeon recommends a mastectomy, you should consider breast reconstruction. Sometimes, reconstructive surgery can be started immediately. In this case, you can choose not to rebuild the breast at all and use a prosthesis or keep it flat. Discuss your choice with your doctor.
You can do the following to prepare for surgery:
- Pack sanitary ware and other essentials in a small bag. Wear a loose-fitting dress that closes with a button or zipper on the front.
- Prepare a small pillow for when you go home and use it to keep your seat belt away from your chest.
- Prepare food and other essential items in advance at home.
You may need help for a few days to a few weeks to fully recover. Try to provide an introduction to the following:
- child care;
- Pet care;
- Personal care.
How is a mastectomy performed?
At the hospital, you will receive fluids and medicine with an intravenous (IV) line in your arm. If you do a sentinel lymph node biopsy, a radioactive tracer will be injected near the tumor. This helps the surgeon find the guard nodes. After general anesthesia, the surgeon makes an incision around the breast and removes the breast tissue. Depending on the type of mastectomy, the dermatologist will remove the aura, nipple, and lymph nodes. Samples of breast tissue and lymph nodes are sent to the lab for testing.
All incisions are then sutured. The surgical team inserts one or two surgical drains (a device to drain the discharge) into the wound. This is a temporary measure to prevent the accumulation of fluid in the breast.
How painful is a mastectomy?
After surgery, you will most likely have pain at the surgical site. Some people also experience the following:
- Numbness and tingling in the chest and upper arm;
- Difficulty moving the arm or shoulder;
- Itching, burning or nerve pain in the chest, armpits, upper arm or shoulder;
- Phantom pain (imagining pain in a limb that does not exist) Chest.
The amount of pain depends on the type of operation, for example, if you have had reconstructive surgery at the same time or have complications, you may experience more pain. Pain and other side effects are different for everyone. You will be prescribed painkillers and you will have less pain if you take it before the pain gets too severe.
Most people get rid of the side effects within a few weeks, but the American Cancer Society says about 20 to 30 percent of women develop post-mastectomy pain syndrome, meaning that the pain and strange feelings remain unknown for some time.
Benefits and complications of mastectomy
The main advantage of mastectomy is the removal of cancerous tissue. Lymph node examination also helps diagnose cancer progression and other treatment decisions.
All surgeries carry the risk of bleeding and infection. A 2020 study found that infections and wound complications are the most common causes of hospital readmission after mastectomy.
Lymph node dissection increases the risk of lymphedema, which leads to:
- Swelling of the arm, hand, fingers, chest or back;
- Limited range of motion;
- Skin discoloration;
What happens after a mastectomy?
Most people recover well after surgery and usually resume normal activities within 6 weeks. The status of breast cancer in the future depends on many factors, including the type of breast cancer and how widespread it is before starting treatment.
Treatment may also include the following:
- Hormone therapy or targeted therapies.
Frequently Asked Questions About Mastectomy
How long after a mastectomy can I return to normal activities and work?
You can do your daily activities after about 4 weeks. If breast reconstruction is also performed, recovery time will be longer and it may take months for you to fully recover.
What happens in the first week after a mastectomy?
In the first week, it is normal to have pain and discomfort around the wound site. If you have had lymph node surgery, you may also have pain in your armpits. Some people feel a tingling or stinging sensation around the scar. This pain gradually decreases.
How should we sleep after a mastectomy?
Patients who have also undergone breast reconstruction are usually advised to sleep on their backs for the first two weeks after surgery. Many women prefer to sit up and sleep in a chair during this time.
When can I take a shower after a mastectomy?
In the first 48 hours after surgery, water should not reach the wound at all. During this time, you should keep the dressing dry to allow the wound to heal over time. After 48 hours, you can remove the dressing and take a shower.
Do you have any experience with breast removal or mastectomy? Please share your comments, experiences and questions with us and our dear users in the comments section.