Mastectomy

If you have breast cancer, it is important for you to decide on a treatment plan that is right for you. It is a good idea to discuss all your treatment options with your health care provider as soon as possible, in order to catch the cancer in its early stages. One of the most common procedures for treating breast cancer is mastectomy. Mastectomy surgery offers many women with breast cancer the chance to live long, fulfilling lives, and it may be an appropriate choice for you. This article will help to keep you informed about the different types of mastectomy and how the procedure is performed.

What is a Mastectomy?
Most women have heard the word "mastectomy" being tossed around from time to time, but few of us are actually familiar with the procedure. A mastectomy is a surgical procedure used in the treatment of breast cancer and helps to preserve your breast health. It involves the removal of your breast, or a part of your breast, in order to stop the spread of breast cancer cells. There are several different types of mastectomies that can be performed, depending upon the stage and type of breast cancer you have.

Who Needs a Mastectomy?
Not every woman who is suffering from breast cancer needs to have a mastectomy. There are other treatments for breast cancer that have similar success rates, which may be a better choice for you. Women who elect to undergo mastectomy surgery generally fit certain guidelines for the procedure. Your health care provider may recommend a mastectomy if you:

  • have cancer in more than one area of your breast
  • have a small breast that is not ideal for lumpectomy
  • are not suited for radiation therapy

Types of Mastectomy
There are four different kinds of mastectomies that are available to breast cancer sufferers. Your health care provider may recommend one type of mastectomy over the other depending upon your health, age, and the stage of your breast cancer.

Partial (Segmented) Mastectomy
Partial mastectomy is the least invasive type of mastectomy. It is frequently performed if you are in the early stages of breast cancer or if you have a small tumor. Partial mastectomy involves removing only a small portion of your breast. Generally, about one-quarter of your breast is removed.

Total (Simple) Mastectomy
With a total mastectomy, your entire breast is removed, including your breast skin and nipple. No axillary (armpit) lymph nodes are removed.

Modified Radical Mastectomy
If you have a modified radical mastectomy, your entire breast, breast skin, and nipple are removed. Some axillary lymph nodes are also removed. This is the most commonly-performed mastectomy procedure.

Radical Mastectomy
The radical mastectomy involves removing your entire breast, breast skin, and nipple, along with your axillary lymph nodes. The muscles in your chest wall are also removed. This procedure is now rarely performed because of the disfigurement that it causes.

Axillary Lymph Node Dissection
Some mastectomy procedures involve the removal of your axillary lymph nodes. These are the lymph nodes found beneath your armpit and just above your breast. Lymph nodes help our bodies to drain fluids and fight infection properly. When you develop breast cancer, cancer cells can sometimes spread to your lymph nodes, indicating a more aggressive form of cancer.

It is sometimes necessary to remove these nodes in order to analyze them for cancer cells. During some mastectomy procedures, between 10 and 40 of your axillary lymph nodes will be removed. These lymph nodes will then be examined under a microscope for cancer cells. The information gained from this analysis can then be used in order to guide future treatment. Side effects of axillary lymph node dissection include:

  • lymphedema, or swelling of the armpit
  • limited arm movement
  • numbness in the upper arm

The Mastectomy Procedure
If you choose to undergo mastectomy treatment, you will meet with you surgeon a few days before your surgery. She will go over the procedure and will answer any questions that you may have. You will be asked to sign a consent form and to stop certain medications that you may be taking. You may also be asked to give some blood in case a transfusion is needed during the procedure. You will not be allowed to eat or drink for about 8 hours before your surgery.

During Surgery
Mastectomy procedures are fairly straightforward and very safe. You will be given general anesthetic, so you will feel no pain during the surgery. You will also be hooked up to special monitors, which will record your heart rate and blood pressure throughout the surgery. You may be given an IV with any medications that you may require.

Your surgeon will make a diagonal or vertical incision around the perimeter of your breast. He will then remove any tissue or lymph nodes that need to be taken out. Your breast will then be reshaped and closed up, using stitches or special clips. If you have elected to have breast reconstruction surgery, this may be performed immediately after the mastectomy. Mastectomies are generally short procedures, taking between 1 and 3 hours, depending upon the procedure you choose.

Recovery and Side Effects
After your breast mastectomy, you will be taken to a recovery room until the effects of your anesthetic wear off. You may notice some breast tenderness around the surgery site. Your breast will be covered with a bandage and you will have a drainage tube that allows blood and fluid to flow out of the wound. Most women remain in hospital for 2 to 3 days, though it depends upon your health and the speed of your recovery. Side effects that you may notice include:

  • fatigue
  • tenderness or mild pain in the breast
  • swelling
  • pulling or stretching sensations under arm
  • hardness due to the mastectomy scar

It is important to exercise your arm so that it does not become stiff after surgery. You will probably receive physiotherapy while you are in hospital and you should continue these exercises when you go home. However, do not take on any strenuous activity for about three or four weeks after your surgery.

Deciding on Mastectomy
Making the decision to have a mastectomy can be very difficult. It can be hard to imagine living without your breast, and you may feel like your identity or femininity is being threatened. The procedure can often be made easier by having breast reconstruction after mastectomy. This helps to reshape your breast and reduce any disfigurement, and may help you to feel more comfortable choosing mastectomy. Ask you health care provider for more information about this option.

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