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When Do Doctors Recommend A Mastectomy?

Submitted by Nic on December 19, 2013

A mastectomy is a surgical procedure in which a part of the breast or the entire breast is removed. This operation is generally performed to treat breast cancer. Women who are at a very high risk of developing breast cancer at a later stage may also choose to undergo this procedure as a preventive measure. However, this is only considered in case of high-risk patients and not everyone.

Normally, before recommending a mastectomy, doctors explore treatment options involving medication, radiation and chemotherapy.

Doctors mainly advise women to undergo a mastectomy in order to get rid of all the cancer cells from the breast. Removing all the cancerous tissue is absolutely essential, because any malignant cells that have been left behind can cause the cancer to come back and maybe even spread to the other parts of the body.

After a diagnosis of breast cancer has been confirmed, the treatment should be carried out without any delay. Early intervention in most types of cancer increases the chance of success and complete recovery. Therefore, once the need for a mastectomy has been established, no time should be wasted in carrying out the procedure.

Types of Mastectomy

Mastectomies can be of different kinds, the most common ones being -

  1. Total or Simple Mastectomy, which involves removal of the breast tissue as well as the nipple
  2. Modified Radical Mastectomy, in which the breast, the lymph nodes below the arm and even the lining of the chest muscles need to be removed
  3. Skin-Sparing Mastectomy, a procedure in which the breast tissue is removed through a small incision that is made around the areola.
  4. Lumpectomy, where only the tumor is removed, along with a small amount of the surrounding tissue

Some of the other types of mastectomy, include -

  1. Radical mastectomy or Halsted mastectomy
  2. Nipple-sparing or subcutaneous mastectomy
  3. Extended radical mastectomy

The type of mastectomy that a woman is asked to undergo may vary, depending upon various factors such as -

  • Stage of cancer
  • Size of the tumor
  • Breast size
  • Involvement of the lymph nodes
  • Patient's age and medical history

Some of the more traditional mastectomy procedures are recommended for -

  • Women who have undergone radiation therapy on the same breast
  • Women with more than one cancer area in the same breast, which are too far away to be removed with a single incision.
  • Women whose lumpectomy hasn't removed the cancer completely
  • Women suffering from severe connective tissue diseases like scleroderma
  • Women who are highly sensitive to the side effects caused by radiation therapy
  • Women with tumors bigger than 2 inches (5 cm), which don't shrink adequately in spite of undergoing chemotherapy
  • Women with malignant tumors that are relatively large for their breasts
  • Women who test positive on the BRCA1 or BRCA2 gene, for deleterious mutation
  • Male breast cancer candidates

Procedure

The steps and procedures involved in each of these surgeries differ. Before the surgery begins, general anesthesia is used on the patient, which causes her to remain unconscious through the procedure. A mastectomy is usually completed in about 2 or 3 hours.

After the surgery, one or two tubes or tiny plastic drains may be left in the chest, for removing the excess fluid. Most women are required to stay over at the medical facility for a day or two.

It is important to remember that though a mastectomy is effective in treating breast cancer, it isn't always the most suitable form of treatment for a woman. In case this procedure is not recommended for someone in particular, her healthcare provider should keep her informed about it.

After undergoing a mastectomy, some women also choose to get a breast reconstruction surgery done.

References

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