Breast mastectomy is a type of surgery in which all the breast tissues is removed as a way of curing or preventing cancer. Mastectomy is actually a very wide term that is used for referring to variety of breast removal procedures. In the past breast mastectomy involved complete removal of breast; however, today women can opt for less invasive breast mastectomy surgeries which are equally effective in treating and preventing cancer.
More than 250,000 were diagnosed with breast cancer in America in 2010 and these numbers are rising every year. With the rising number of breast cancer patients it is important to understand few facts about breast mastectomy, which is one of the most effective treatment options available to breast cancer patients.
When is Breast Mastectomy Recommended by Doctors?
A person who has been diagnosed with stage 1 or 2 of breast cancer or with noninvasive breast cancer (ductal carcinoma in situ) will be advised to undergo mastectomy. If a patient has locally advanced (stage 3) breast cancer, mastectomy will be done after chemotherapy.Chemotherapy will help bring down the size of the tumor. Women who have inflammatory breast tumor or cancer are also advised mastectomy after undergoing chemotherapy.
Mastectomy might also be recommended by doctors, if you have localized recurrent breast cancer or Paget’s disease. When tumor is present in more than one location in the breast, doctors will advise you to undergo breast mastectomy. Mastectomy is also advised when the size of the tumor is large in comparison to the size of the breast.
For Pregnant Women Pregnant women with breast cancer are advised to undergo breast mastectomy rather than undergo radiation therapy, because radiation poses a risk to the unborn baby. Malignant Calcium Deposits If the breast biopsy result shows that the calcium deposits, known as microcalcifications are malignant, then the doctor will advise the patient to undergo mastectomy.
Cancer Cell Still Present In a situation in which a woman has undergone lumpectomy, but the cancerous cells are still present around the edges of the operated area or in the other areas of the breast, the doctor will then advise breast mastectomy. In Connective Tissue Disease Breast cancer patients who suffer from connective tissue disease like, lupus or scleroderma might not be able to tolerate radiation’s side effects. They are thus advised to undergo mastectomy.
Preventive/Prophylactic Mastectomy
Presence of cancer or tumor is not always the determining factor for doctors when advising breast mastectomy to their patients. If a woman has a high risk of getting breast cancer, she will be advised to undergo mastectomy as a way of preventing cancer. Such type of mastectomy is termed as prophylactic mastectomy.
The doctor’s recommendation for prophylactic mastectomy will be based on family’s breast cancer history, presence of BRCA2 or BRCA1 gene mutations, and/or your personal breast cancer history. Prophylactic mastectomy reduces the risk of developing cancer by 90%. Your age, overall health, and menopause status are some of other factors that the doctor will consider when determining whether breast mastectomy is the right treatment option for you or not.
Types of Mastectomy
There are several different types of mastectomy surgeries. The type of mastectomy recommended will depend on the type of cancer that you have.
Radical Mastectomy
Radical mastectomy involves the removal of the entire breast. The nipple is also removed in radical mastectomy. The overlying skin is removed during the surgery. In this surgery, Level I, II and III lymph nodes located in the underarm are also removed. Chest wall muscles located under the breast are also removed.
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Though this procedure is quite effective, it leaves behind a very ugly scar. This experience can be quite traumatic for some women. The good news is that radical mastectomy is rarely used nowadays, because there is a less traumatic and equally effective procedure available today.
Modified Radical Mastectomy
In MRM the entire breast is removed including the nipple, skin, areola, most of the lymph nodes and breast tissue. The lining over the chest muscle is removed; however, the muscle itself is not removed. This surgery does not leave an ugly hollow scar and is less invasive, though equally effective as radical mastectomy. MRM is usually recommended when the tumor is large or the lymph nodes have been affected by cancer.
Simple or Total Mastectomy
This procedure involves the removal of the entire breast, including the nipple, breast tissue, areola and skin. However, the lymph nodes are not removed in every case. Lymph nodes are only removed if they are present within the breast tissues that are removed during surgery. Breast muscles are also not removed in a simple mastectomy. Simple mastectomy is usually recommended in cases involving multiple ductal carcinomas in situ.
Partial Mastectomy
Partial mastectomy involves the removal of only the breast part that contains the cancer. After surgery radiation therapy is given in order to kill the remaining cancer cells and to prevent them from spreading or recurring.
Subcutaneous Mastectomy
This surgery is also known as nipple-sparring mastectomy. This procedure involves the removal of breast tissue only. Nipple, skin, areola and chest muscles are not removed. During this surgery, doctors usually perform a sentinel lymph node biopsy to determine whether the cancer has spread to the lymph node or not. Breast reconstruction is done immediately after the surgery.
Risks Associated With Mastectomy
Just like other surgeries breast mastectomy also carries certain risks. Immediately after the surgery you might feel pain in the shoulder and in the breast area. Doctors usually prescribe pain medication after the surgery. There is always the risk of infection setting in the operated area. If this happens, antibiotics are prescribed. If during the surgery lymph nodes are removed, then there is always a chance that fluid might build up in the arm.
Fluid might also build up around the healing area. If this happens, further surgery might be required. Some women develop raised or red scars that might take years to fade away. Some women might experience change or loss in sensation in the breast or the operated area. This can be temporary or permanent.
Other possible side effects include soreness, bruising, tightness and swelling in arm, shoulder or/and breast. If the lymph nodes were removed, the patient might feel numbness under the arm. Since the operation is done under anesthesia, there is a chance that excessive bleeding might occur as a possible side effect to anesthesia. Another side effect of anesthesia includes formation of a blood clot in a vein in your leg, a condition called deep vein thrombosis.
Prophylactic Mastectomy Risks
Though the surgery reduces breast cancer risk by 90%, it does not mean that it can never happen. Moreover, those women who decide to undergo prophylactic mastectomy need to understand that it is permanent. Breastfeeding (from the operated breast) will no longer be an option for women who undergo prophylactic mastectomy. Many women have reported feeling depressed about their body after the surgery.
This surgery leads to loss of sensation in the breast and this can have an effect on the patient’s sexuality. At present breast mastectomy is a very effective treatment option for all types of breast cancer. Understanding this surgery and the associated risks will help you get mentally prepared for this surgery and this will turn help you recover faster after the surgery.
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