Mastectomy Cancer Treatment

Introduction – Mastectomy

Mastectomy involves surgical removal of whole or part of the breasts usually due to breast cancer.

Patient’s age, general health status, stage of cancer, responsiveness to anticancer chemotherapy and radiation, rapidity of tumor growth, involvement of lymph nodes and menopause often determine the extent of surgery that is required for her.

Procedure and considerations – Mastectomy

Most women recover from this operation with no complications. Small but significant risks with this operation include bleeding, pain, nerve injury and anesthetic complications like heart attack, stroke or even death.

There is no alternative to mastectomy in advanced cases of breast cancer. However choice of one of the partial mastectomy procedures can be made depending on the stage of the cancer. Cancer chemotherapy, radiation therapy, hormonal therapy is often given as an adjuvant to mastectomy in breast cancer patients.

Before the surgery is undertaken a general health check up is mandatory. Patient will need to be empty stomach for 6 to 8 hours before the surgery. Usually a light dinner is recommended. Food or water in the stomach when under anesthesia can go into her lungs and may even cause death. Once inside the operation theatre an intravenous line will be made in one of the veins of the patient’s forearm. She may be given medications to allay anxiety before the operation. Instruments to monitor the heart rate, rhythm (using EKG), blood pressure and oxygen saturation (to detect adequacy of breathing) will then be plugged in. Usually general anesthesia is advocated for mastectomy. Patient will be made unconscious during the operation with a breathing tube – endotracheal tube in place to help her breathe through a breathing machine or ventilator.

After cleaning the operative area sterile surgical drapes are placed around it. The surgeon then makes an incision over the skin of the breast and proceeds to dissect out the underlying tissues of the breast. The tumor is sent for histopathological examination under the microscope by a pathologist.

Patient is advised not to lift weights or exercise for a few weeks after the operation.
There are various types of mastectomy. In a partial mastectomy only a part of the tumor containing breast tissue may be removed leaving the rest of the breast intact. This is undertaken in the early stages of the cancer. A complete or radical mastectomy is performed in advanced stages of the cancer. In this operation the whole of the breast tissue, nipple, skin and muscles and the lymph nodes in the arm pits and around the breast are removed. Another form of radical mastectomy is the Modified Radical Mastectomy or MRM wherein the muscles of the chest (pectoral muscles) are preserved. The skin overlying the breast may or may not be preserved. A Skin Sparing (SSM) or Nipple Sparing (NSM) mastectomy may be opted for depending on the extent of the cancer and its spread.

Depending on the type of mastectomy undertaken the operation may take one to two hours or more. Once the mastectomy is completed a plastic surgeon may be ready to perform a reconstruction surgery immediately. A reconstruction can also be performed at a later date. Usually muscles flaps of the abdomen or artificial saline or silicone filled bags can be used for reconstruction of the breast.

After the surgery is completed skin is sutured or staples leaving drainage tube in place to drain out the excess fluids. The operative site is then bandaged.

Patient will then be taken to the recovery area where she will be awakened and given medications for pain relief. After her vital signs are stabilized she may be shifted to the hospital bed. In most cases she may need to stay for up to a week in the hospital. Patient will be given antibiotics and pain relievers for a few days after the operation. Patient is advised not to lift weights or exercise for a few weeks after the operation. Any bleeding, fever or increase in pain needs to be brought to the attention of the caregiver immediately. At the first follow up visit after a week the stitches and the drainage tube may be removed.

- Link of interest: Twitter Mastectomy – Cancer Treatment.

 

This article is not medical advice nor a substitute to professional health advice. Always consult a doctor.

 

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