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Mastectomy

Mastectomy

Mastectomy is a surgical procedure conducted to remove all breast tissue in order to treat breast cancer. For breast cancer in early stages, mastectomy surgery Is currently the best treatment option, which Is considered a local therapy, targeting only the area of the tumor.

Mastectomy Is medically safer, but a more drastic solution than lumpectomy, a breast-conserving surgery in which only the tumor Is removed. In case of high-risk patients, double mastectomy (bilateral mastectomy) Is often recommended as a preventive measure to stop cancer from spreading to the other breast. Mastectomy surgery makes use of advanced techniques which nowadays preserve breast skin and allow a more natural appearance later on. After the necessary cancer treatment and mastectomy, reconstruction surgery strives to give back breasts a close to normal appearance with implants and skin graft if need be.

The Mastectomy Procedure

Due to breast cancer or a high risk of developing it, mastectomy may be performed to remove one breast or both (bilateral mastectomy). The most common types of breast cancer treated with mastectomy include:

  • Locally recurrent breast cancer
  • Paget’s disease
  • Inflammatory breast cancer
  • Ductal carcinoma or noninvasive breast cancer
  • Early stages of breast cancer
  • Locally advances after chemotherapy

In some cases, doctors may recommend mastectomy along with radiation, when:

  • The patient has two or more tumors in separate areas
  • The patient has cancerous microcalcifications throughout the breast
  • Recurrent cancer after radiation treatment
  • The patient is pregnant
  • The patient carries a gene mutation
  • The tumor is too big for cosmetic reconstruction after the procedure
  • The patient suffers from connective tissue disease (scleroderma, lupus)

When there is a recurring family history of breast cancer, the mastectomy procedure is performed to prevent the disease.

Before mastectomy surgery, the surgeon and the anesthesiologist will review the medical history of the patient and determine the plan of action, bearing in mind the reconstructive method selected.

The mastectomy procédure Is performed at the clinic under general anesthesia, and may go as follows:

  • An elliptical incision is made around the breast
  • Breast tissue, fat and skin are removed
  • Lymph nodes are removed and sent to the lab
  • During mastectomy reconstruction, temporary tissue expanders are implanted
  • The incision is sutured.

There are six types of surgical approaches, depending on the size, location and behavior of the tumor.

Corresponding to these conditions, the distinct types of mastectomy include:

  • Simple mastectomy – the entire breast is removed.
  • Radical mastectomy – the entire breast tissue, fatty tissue and lymph nodes are removed. It is reserved for recurrent breast cancer.
  • Modified radical mastectomy – pectoral muscles are spared
  • Skin-sparing mastectomy – which highly facilitates breast reconstruction
  • Subcutaneous mastectomy – nipple complex is preserved
  • Extended Radical Mastectomy – it involves a standard radical mastectomy along with the removal of the inner mammary nodes as well.

Post- Mastectomy Reconstruction

During the surgery, the breast mound is rebuilt so that it will be of nearly the same size and shape as before. Thanks to advances in prostheses manufacturing, nipples and aureolas can also be constructed with wonderful outcomes. 

The reconstructive procedure might involve the use of:

  • Breast expanders
  • Gel or silicone implants
  • Own tissue for autologous tissue reconstruction
  • A combination of tissue and implants

Plastic or reconstructive surgeons usually perform these complex operations. Prior to the latter, it is important to inform the doctors about any medications, vitamins or supplements taken and to stop taking blood-thinning medication.

Among the reasons for choosing double mastectomy reconstruction, we find:

  • The desire to make the chest look balanced
  • To regain breast shape

Breast reconstruction is a cosmetic procedure, and is performed by a plastic surgeon. Always ask several surgeons about the best options for your specific condition !

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