Mastectomy – Removal of the Breast

A radical mastectomy removes the breast, all the axillary nodes and the pectoral muscles. With a modified radical mastectomy the pectoral muscles are not removed. An extended radical mastectomy removes the internal mammary nodes in addition to the standard radical procedure and in a simple mastectomy, the entire breast is removed, leaving the axillary nodes intact. Be sure you understand the rationale for any recommended procedure, the risks and benefits involved and any possible alternative treatments. Breast reconstruction is usually feasible and should be discussed prior to a mastectomy.

REASONS FOR PROCEDURE

Cancer of the breast.

RISK INCREASES WITH

  • Obesity or poor nutrition.
  • Smoking; stress.
  • Recent or chronic illness.
  • Use of drugs such as antihypertensives; muscles relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
  • Use of mind-altering drugs.

DESCRIPTION OF PROCEDURE

  • A general anesthetic is administered by injection and inhalation with an airway tube placed in the windpipe.
  • An incision is made encompassing the entire breast.
  • The underlying tissue is cut free and removed in one piece with the lymph glands from the armpit. Bleeding is controlled with sutures and electrocauterization. A tube is inserted for drainage. The drain is generally removed by your doctor within the first few days following the procedure.
  • The skin is closed with sutures or surgical clips, which usually can be removed about 1 week after surgery.

EXPECTED OUTCOME

Expected complete healing of the surgical wound. Allow about 6 weeks for recovery from surgery.
This procedure usually involves joined management by a Gynaecologist and a Breast Surgeon.
If you are 35 years and above , ask your Gynaecologist about Mammography and screening for breast cancer

POSSIBLE COMPLICATIONS

  • Excessive bleeding.
  • Surgical-wound infection.
  • Depression.
  • Accumulation of blood under the skin in the surgical area.
  • Limited shoulder motion.
  • Nerve damage.

POSTPROCEDURE CARE
GENERAL MEASURES

  • A hard ridge should from along the incision. As it heals, the ridge will recede gradually.
  • Use an electric heating pad, a heat lamp or a warm compress to relieve incisional pain.
  • Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
  • Move and elevate your legs often while resting in bed to decrease the likelihood of deep-vein clots.
  • A breast prosthesis can be used if desired.
  • Seek help from friends or family or support groups to help you learn to cope with the emotional feelings.
  • Swelling (edema) can be reduced in the affected arm by elevating it frequently.

ACTIVITY

  • To help recovery and aid your well-being, resume daily activities, including work, as soon as you are able.
  • Avoid vigorous exercise for 6 weeks after surgery. Physical therapy and/or special exercises are usually prescribed (to help speed recovery and reduce complications).
  • Resume driving 2 weeks after returning home.
  • Resume sexual relations when able.

DIET

Clear liquid diet until the gastrointestinal tract functions again. Then eat a well-balanced diet to promote healing.