Mastectomy

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Mastectomy
Intervention
Mastectomie 02.jpg
Mastectomy patient
ICD-9-CM85.4
MeSHD008408
MedlinePlus002919
 
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Mastectomy
Intervention
Mastectomie 02.jpg
Mastectomy patient
ICD-9-CM85.4
MeSHD008408
MedlinePlus002919

Mastectomy (from Greek μαστός "breast" and ἐκτομή ektomia "cutting out") is the medical term for the surgical removal of one or both breasts, partially or completely.

A mastectomy is usually carried out to treat breast cancer. In some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, as a preventive measure. It is also the medical procedure carried out to remove breast cancer tissue in males. Alternatively, some patients can choose to have a wide local excision, also known as a lumpectomy, an operation in which a small volume of breast tissue containing the tumor and a surrounding margin of healthy tissue is removed to conserve the breast.

Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

Traditionally, in the case of breast cancer, the whole breast was removed. Currently the decision to do the mastectomy is based on various factors including breast size, number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of tumor recurrences after lumpectomy and radiation. Outcome studies comparing mastectomy to lumpectomy with radiation have suggested that routine radical mastectomy surgeries will not always prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis, and operation.[citation needed]

Types[edit]

Currently, there are several surgical approaches to mastectomy, and the type that a patient decides to undergo (or whether she or he will decide instead to have a lumpectomy) depends on factors such as the size, location, and behavior of the tumor (if one is present), whether or not the surgery is prophylactic, and whether the patient intends to undergo reconstructive surgery.

Before surgery[edit]

Before the operation everyone will meet with the surgeon a few days before the surgery or even the day before. During this time the extent and specific details regarding the mastectomy will be discussed along with the patients medical history. The patient will have time to ask any questions regarding the procedure at this time and after everything is addressed a consent form is signed. Information about not eating or drinking anything beforehand will be gone over as well. The patient will also meet with the anesthesiologist or the health professional who is going to be giving the anesthesia the day of the operation.[7]

During surgery[edit]

The day of the operation the patient will have an IV line started, which will be used to give medicine. Since this an extensive procedure the patient will be hooked up to an EKG machine and also have a blood pressure cuff to monitor vitals and the heart rhythm throughout the whole surgery. The anesthesia will be given, which will result in the patient going to sleep. The timing of the surgery all depends on the extent and what type of mastectomy the patient will be having.[7]

After surgery[edit]

When the procedure is complete the patient will be taken to a recovery room where they are monitored until they wake up and their vital signs remain stable. It is normal for women that have mastectomies to remain in the hospitals for 1 to 2 nights and then are released to go home if they are doing well. The decision for discharge should be made by the doctor based on the patients overall health at the time. The patient is going to be dressed with a bandage over the surgery site that is wrapped around the chest snugly. It is common to have drains coming from the incision site to help remove blood and lymph to initiate the healing process. Patients may have to be taught to empty, care, and measure the fluid from the drains. Measuring the fluids will help identify any problems the doctors need to be aware of. Patients should be taught the effects of the surgery, such as regular activity may be altered. There is a possibility that pain, numbness, or tingling in the chest and arm could continue long after the surgery has been done. It is recommended that patients see their surgeon 7–14 days after the surgery, during this time the doctor will explain the results and talk about further treatment if needed such as radiation and chemotherapy. The doctor might refer the patient to a plastic surgeon if they showed interest in breast reconstruction surgery.[7]

Possible side effects[edit]

According to cancer.org, aside from the post-surgical pain and the obvious change in the shape of the breast(s), possible side effects of a mastectomy include wound infection, hematoma (buildup of blood in the wound), and the seroma (buildup of clear fluid in the wound). If the lymph nodes are also removed, additional side effects may occur.[7]

Indications[edit]

Despite the increased ability to offer breast-conservation techniques to patients with breast cancer, certain groups may be better served by traditional mastectomy procedures including:

Epidemiology[edit]

Mastectomy rates vary tremendously worldwide, as was documented by the 2004 'Intergroup Exemestane Study',[8] an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries. The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.

History[edit]

Mastectomy for breast cancer was performed at least as early as 548 AD, when it was proposed by the court physician Aëtius of Amida to Theodora. She declined the surgery, and died a few months later.[9]

Female members of the Skoptsy sect in Tsarist Russia also practiced mastectomy as a ritual alongside castration for men, in accordance with their belief that sexual desire was evil.[10]

Role In modern design[edit]

Mastectomy clothing is currently one of the fastest growing areas of the fashion world. Many designers are catering to more diverse groups of women, including those who have undergone transformative surgery. Cosmetic and hygiene companies like Dove, with their Dove Campaign for Real Beauty have launched campaigns in recent years promoting a great acceptance of female bodies, helping to reverse the reputation of the fashion world as being promotors of unhealthy body images. Other designs have catered to the medical market and those affected by surgical procedure. Many dresses designed with this market in mind have built in padded cups or have pouches so that inserts of various sizes can be place in either or both cups of the garment. Some fashion designers even produce mastectomy swimwear with a similar format in mind[11]

See also[edit]

References[edit]

  1. ^ a b c "What Is Mastectomy?" Breastcancer.org. N.p., 16 May 2013. Web. 03 Aug. 2014.
  2. ^ Gerber B, Krause A, Reimer T, et al. (2003). "Skin-sparing mastectomy with conservation of the nipple-areola complex and autologous reconstruction is an oncologically safe procedure". Ann. Surg. 238 (1): 120–7. doi:10.1097/01.SLA.0000077922.38307.cd. PMC 1422651. PMID 12832974. 
  3. ^ Mokbel R, Mokbel K (2006). "Is it safe to preserve the nipple areola complex during skin-sparing mastectomy for breast cancer?". Int J Fertil Women's Med 51 (5): 230–2. PMID 17269590. 
  4. ^ Sacchini V, Pinotti JA, Barros AC, et al. (2006). "Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem?". J. Am. Coll. Surg. 203 (5): 704–14. doi:10.1016/j.jamcollsurg.2006.07.015. PMID 17084333. 
  5. ^ Noguchi, M; Sakuma, H; Matsuba, A; Kinoshita, H; Miwa, K; Miyazaki, I (1983). "Radical mastectomy with intrapleural en bloc resection of internal mammary lymph node by sternal splitting.". The Japanese journal of surgery 13 (1): 6–15. PMID 6887660. 
  6. ^ "Preventive Mastectomy for Breast Cancer." WebMD. WebMD, n.d. Web. 04 Aug. 2014.
  7. ^ a b c d "Surgery for Breast Cancer." Surgery for Breast Cancer. N.p., n.d. Web. 02 Aug. 2014.
  8. ^ "Federation of European Cancer Societies". Archived from the original on 2007-11-28. Retrieved 2007-12-03. 
  9. ^ Olson, James Stuart (2002). Bathsheba's breast: women, cancer & history. Baltimore: The Johns Hopkins University Press. p. 11. ISBN 0-8018-6936-6. 
  10. ^ "From Heresy to Harm: Self-Castrators in the Civic Discourse of Late Tsarist Russia". 
  11. ^ "Mastectomy In The Fashion World". 

External links[edit]