Mastectomy simply means the removal of breasts or a breast cancer surgery that removes the entire breast. It may sound simple, but the amount of both mental and physical pain that the patient undergoes is extreme. Breasts are just like any other organ of our body. Removal is as exhilarating on the body as any other body part and can cause tremendous amounts of stress and anxiety along with both mental and physical turmoil.
Mastectomy is done only under circumstances where a female cannot be treated with breast conserving surgery or lumpectomy which saves most of the parts of the breast.
Types of mastectomy:
There are different types of mastectomies depending upon how the surgery is done and how much tissue is removed:
Simple or total mastectomy
In this procedure, the surgeon removes the entire breast, including the nipple, areola, fascia (covering) of the pectoralis major muscle (main chest muscle), and skin. A few underarm lymph nodes might be removed.
Modified radical mastectomy
A modified radical mastectomy combines a simple mastectomy with the removal of the lymph nodes under the arm.
Radical mastectomy
This extensive surgery is rarely done now. The surgeon removes the entire breast, axillary (underarm) lymph nodes, and the pectoral (chest wall) muscles under the breast. This surgery was once very common, but less extensive surgery (such as the modified radical mastectomy) has been found to be just as effective and with fewer side effects. This operation might be done if the tumor is growing into the pectoral muscles.
Skin sparing mastectomy
In this procedure, most of the skin over the breast is left in place. Only the breast tissue, nipple, and areola are removed. The amount of breast tissue removed is the same as with a simple mastectomy. Implants or tissue from other parts of the body can be used during the surgery to reconstruct the breast. Many women prefer a skin-sparing mastectomy because it offers the advantage of less scar tissue and a reconstructed breast that seems more natural. But it may not be suitable for larger tumors or those that are close to the surface of the skin. The risk of local cancer recurrence with this type of mastectomy is the same as with other types of mastectomies.
Nipple sparing mastectomy
A nipple-sparing mastectomy is similar to a skin-sparing mastectomy in that the breast tissue is removed and the breast skin is saved. But in this procedure, the nipple and areola are left in place. This can be followed by breast reconstruction. The surgeon often removes the breast tissue under the nipple and areola during the procedure to check for cancer cells. If cancer is found in this tissue, the nipple and areola must be removed. This type of mastectomy is more often an option for women who have a small, early-stage cancer, away (more than 2cm) from the nipple and areola, with no signs of cancer in the skin or the nipple. After the surgery, the nipple may not have a good blood supply, causing the tissue to shrink or become deformed. Because the nerves are also cut, there often may be little or no feeling left in the nipple. If a woman has larger breasts, the nipple may look out of place after the breast is reconstructed. As a result, many doctors feel that this surgery is best done in women with small to medium sized breasts. This procedure leaves fewer scars you can see, but it also has a risk of leaving behind more breast tissue than other forms of mastectomy. This could result in a higher risk of cancer developing than for a skin-sparing or simple mastectomy.
Double mastectomy
When both breasts are removed, it is called a double or bilateral mastectomy. Double mastectomy is sometimes done as a risk-reducing or preventive surgery for women at very high risk for getting breast cancer, such as those with a BRgene mutation. Most of these mastectomies are simple mastectomies, but some may be nipple-sparing. There are other situations where a double mastectomy might be done as part of a women's breast cancer treatment plan.
Clinical issues/complications after removal of breast
Bleeding and infection at the site of surgery may occur in case of most of the surgeries. The side effects of mastectomy depend on the type of surgery you may have undergone. Few side effects may include:
· Post mastectomy pain syndrome(PMPS)-Burning or shooting pain in the chest wall, armpit or arm that doesn’t go away over time.
· Numbness in the chest or upper arm.
· Restricted arm or shoulder movement.
· Swelling or pain at the surgery site.
Recovering from a mastectomy
In general, women undergoing a mastectomy stay in the hospital for 1 or 2 nights and then go home. How long it takes to recover from surgery depends on what procedures were done, and some women may need help at home. Most women should be fairly functional after going home and can often return to their regular activities within about 4 weeks. Recovery time is longer if breast reconstruction was also done, and it can take months to return to full activity after some procedures. The most common question lingering in the minds of a female who has undergone a mastectomy is, “whether the cancer can return back” .This question is a bit tough to answer but research says that the chances of cancer recurring after mastectomy is very rare.However,mastectomy is not a simple surgery it requires a lot of courage.The pain of losing ones organs is inexplicable.The scars of mastectomy will remain forever but it will remind them of their victory over cancer.
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