What is Mastectomy?
Mastectomy is a surgery performed to remove all breast tissues from a breast, in case of breast cancer. This procedure is majorly sought by women in early-stage breast cancer.
Mastectomy is a general procedure under which several techniques are performed including one or both breasts. In some cases, the surgeon may also remove surrounding lymph nodes, to check if cancer has spread.
In an axillary node dissection, the surgeon would remove the number of lymph nodes from your armpit around the tumour.
Whereas, in a sentinel lymph node biopsy, the surgeon would remove only the initial few nodes into which a tumour drains. These lymph nodes removed during a mastectomy are then tested for cancer.
What are the treatment types for Mastectomy?
Mastectomy is classified into different types based on the area of a breast removed.
Radical Mastectomy
Radical Mastectomy is a procedure that involves the removal of the breast tissue and most of the lymph nodes.
Total Mastectomy
A total mastectomy is also referred to as Simple Mastectomy. The procedure involves the removal of the entire breast, areole, breast tissues, and nipples.
This procedure is often accompanied by sentinel lymph node biopsy.
Skin-sparing Mastectomy
This procedure also involves the removal of the breast tissue, areole, nipple, but not the breast skin.
The process of a sentinel lymph node biopsy is usually performed with the skin-sparing mastectomy. In case some patient wants to opt for breast reconstruction, the procedure can be performed immediately after the mastectomy.
However, it should be noted that the skin-sparing mastectomy may not be the right procedure for larger tumors.
Nipple-sparing Mastectomy
Nipple-sparing mastectomy procedure involves the removal of only the breast tissues sparing the nipple, breast skin, and areole.
It can be accompanied by a sentinel lymph node biopsy. A breast reconstruction procedure can also be performed immediately after the mastectomy.
Total (simple) Mastectomy
In Total mastectomy, the surgeon removes the whole breast including the nipple, areola, and skin as well as one or more of the axillary lymph nodes in the breast tissue that needs to be removed. No muscles from underneath the breast are removed.
A simple mastectomy usually opts in women with ductal carcinoma, which is present in a large area or multiple areas.
In case the surgery is performed on both breasts, it is called a double mastectomy. Double mastectomy might be chosen by some patients or consulting doctors as a preventive measure.
Total mastectomy procedures usually require a brief stay in the hospital. In some cases, a drainage tube is placed attached to a bag, within the incision. This is to drain the subcutaneous fluid and is usually removed several days after surgery.
Modified Radical Mastectomy
During this procedure, the surgeon removes all of the breast tissue including the nipple and areola as well as axillary lymph nodes.
The muscles beneath the breast are however not removed. This procedure is performed in cases of invasive breast cancer.
The surgery involves removing a large portion of the lymph nodes that would indicate the extent of cancer.
Therapies like radiation, chemo, and hormone are usually followed post radical mastectomy depending upon the individual case.
How to prepare for Mastectomy?
In case you are undergoing a sentinel node biopsy along with mastectomy, before your surgery a radioactive tracer and a coloured dye are injected around the tumour.
The tracer and the coloured dye visit the nodes and help in locating the nodes, therefore assisting the surgeon in removing them during the procedure.
Also, keep your doctor posted on any specific medications or supplements you are taking.
You will be instructed by the doctor to not eat or drink at least 8 to 12 hours before surgery.
What to expect during Mastectomy?
Mastectomy is performed under general anaesthesia.
The surgeon would make an elliptical incision around the breast and then as per the opted procedure, the breast tissues or other parts of the breast are removed.
Mastectomy and reconstruction are usually well coordinated and performed at one go. The surgery is completed with sutures on the incision.
What to expect after the Mastectomy?
Post-procedure the patient is taken to a recovery room and monitored on the blood pressure, breathing and pulse. Once stabilized the patient will be shifted to your hospital room.
The patient might feel some pain, numbness, and pinching sensation around the underarm area.
Both procedures together mastectomy, as well as reconstruction of the breast, will take a few hours.
Mastectomy being an outpatient procedure, the patient can go home the same day.
When both the breasts are to be operated on, the patient will be required to stay back in the hospital for more time. Mastectomy and breast reconstruction might take furthermore stay back in the hospital.
