Mastectomy

Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely.

Types

• Subcutaneous mastectomy: If the gland is removed only but the skin of the breast, areola and nipple is preserved.

• Simple mastectomy: The removal of the full breast, including the skin that covers it, areola and nipple.

• Radical mastectomy: The removal of the complete breast accompanied by the lymph nodes of the axill and variable portions of the breast muscles. In the modified radical mastectomy the pectoral muscles are preserved or at most removed only the minor pectoral to facilitate access to the innermost region of the axillary lymph nodes, is a non-preservative surgery, as it does not conserve the breast gland, but does not perform axillary vaciation as in radical mastectomy.

• Prophylactic mastectomy: This procedure is used as a preventive measure against breast cancer. Surgery aims to remove all breast tissue that could potentially become breast cancer. Surgery is usually considered when the person has BRCA1 or BRCA2.mutations in his or her genes. The tissue that is located right under the skin to the chest wall and around the edges of the breast should be removed from both breasts during this procedure. Because breast cancer develops in the glandular tissue, ducts and lobes should also be removed. Because the region is so wide, from the clavicle to the lower margin of the rib and from the middle of the chest around the side and under the arm, it is very difficult to remove all the tissue. This genetic mutation is a high-risk factor for the development of breast cancer, family history or atypical lobulillar hyperplasia (when irregular cells cover the lobes of milk). This type of procedure is said to reduce the risk of breast cancer by 100%. However, other circumstances may affect the result.

For what it is done

Mastectomy is usually done to fight breast cancer; In some cases, women who are at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. In contrast, in a lumpectomy, only a piece of tissue is removed instead of the entire breast.

Diagnosis

Often the mastectomy was performed during the same operation in which the biopsy was taken to confirm the diagnosis. Today, the decision to perform a mastectomy is usually based on a previously performed biopsy. Also, there is a trend towards more conservative treatment with breast cancer. Practice has changed, on the one hand, due to improvements in radiotherapy and adjuvant treatment (for example, chemotherapy and hormonal therapy) and on the other hand, earlier recognition of breast cancer metastasis.

Forecast

Radical excision will not prevent against later secondary tumors that occur as a result of micro-metastases that have occurred before the cancer was discovered. In the most developed countries only a minority of new cases of breast cancer are treated with mastectomy.

Breast reconstruction

Plastic surgery comes to offer a therapeutic option to recover the lost identity and improve the quality of life. With breast reconstruction, an attempt is made to repair the psycho-physical damage produced by oncological surgery. Between oncological treatment and reconstructive treatment, it is necessary to monitor the patient, during this period, by psychologists (psychotherapy).