Mastectomy is considered a major surgery for the below reasons:
- The procedure involves permanent removal of either one or both breasts, which itself is a major risk factor.
- Usually, the procedure may last up to 4 hours depending on the severity of the disease.
- It is performed under general anesthesia.
- Patients may also need to stay in the hospital for a few days depending on their recovery rate.
- It is a physically and emotionally draining procedure.
What is a mastectomy?
Mastectomy is a surgical procedure that involves either partial or total removal of breast tissue to treat or prevent breast cancer and reduce the chances of developing breast cancer. Breast reconstruction may be done along with this surgery.
There are different types of mastectomy techniques and they are:
- Total mastectomy: In this surgery, the entire breast is removed, but not the lymph nodes under the arm or the muscle tissue beneath the breast. Sometimes both breasts are removed, especially when mastectomy is done to try to prevent cancer.
- Partial mastectomy: Where your doctor removes only the part of the breast that has turned cancerous along with some surrounding tissue.
- Tissue- and nipple-sparing mastectomy: For women who are planning on having reconstruction right away, a skin/tissue-sparing mastectomy can be done. With this procedure, most of the skin over the breast (other than the nipple and areola) is left intact. This can work as good as a simple mastectomy. The amount of breast tissue removed is the same as with a simple mastectomy. Women usually prefer it because there is less scar tissue, and the reconstructed breast seems more natural.
- Nipple-sparing mastectomy: This is like a skin-sparing mastectomy, but the nipple and areola are left behind. This procedure is more often an option for women who have a small, early-stage cancer near the outer part of the breast, with no signs of cancer in the skin or near the nipple.
- Radical mastectomy: In this procedure, the surgeon removes the entire breast, many of the lymph nodes under the arm, and the muscles of the chest wall under the breast. This procedure is usually done if cancer is growing into the muscles under the breast.
- Modified radical mastectomy: In this surgery, the entire breast is removed along with lymph nodes under the arm or axillary lymph node dissection.
When is mastectomy recommended?
Doctors may recommend a mastectomy if a patient has:
- People suffering from breast cancer that cannot be treated with other options
- Two or more tumors located in different areas of the breast
- The tumor is big, relative to the size of your breast
- Multiple calcium deposits that have tested positive for cancer
- A gene mutation that puts the patient at high risk
- A connective tissue disorder that limits the body’s tolerance for radiation
- Lumpectomy's failure in removing tissue entirely
What are the common side effects of mastectomy?
Patients who have had a mastectomy may stay in the hospital for a few days depending on the type of surgery. Patients who have immediate reconstruction following their mastectomy may stay a little longer. Following a mastectomy, many women go home with drains in their chests. The surgeon may remove the drains during a follow-up office visit. Other side effects may include:
- Fatigue
- Numbness and tingling
- Stiffness in the shoulder
- A buildup of fluid around the scar (seroma)
- Changes in sensation in the breast, nipple, or arm
- Fluid buildup and arm swelling after lymph node removal (lymphoedema)
- Infection
- Bleeding
- Pain and stiffness of the shoulder
- Swelling
- Pain
- Skin loss at the site of the surgery
- Buildup of blood
- Hard scar at the site of the surgery
What is the outlook of the patients after mastectomy?
Most people who have a mastectomy recover well. The patient may probably feel sore for a few days and maybe on painkillers or antibiotics for a few days. Wounds may take around 2 to 3 weeks to heal, but it may take several months to fully recover chest and arm areas. As per research, the success rate of mastectomy is under 85%; however, cancer recurrence cannot be ruled out. It is most effective in treating early-stage breast cancer. Overall recurrence rates are decreasing and survival rates are holding strong.
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