Mastectomy, breast cancer treatment or breast removal operation

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Did you know that breast cancer is one of the most common cancers that affects many people around the world? Even in rare cases, it has been seen that some men also suffer from this disease.

There are many promising treatments for this type of disease that can be very exciting. One of these treatment methods is mastectomy surgery, in which the breast tissue is completely removed.

There are different types of this surgery, each of which is recommended by the doctor under the influence of certain conditions and factors. Knowing the different types of this surgery, the necessary measures for before and after the operation, the complications, and knowing the tips you need to do to recover, is the first step you take for your treatment.

In this article, we have discussed all the points that you should be aware of so that you can make a more informed decision about your treatment.

What is mastectomy surgery?

When breast cancer reaches its peak and it is necessary to remove the damaged tissue, mastectomy is used. In this surgery, the breast tissue is completely removed and this is done to treat breast cancer in men and women.

The mastectomy operation is performed in a short time and takes about 90 minutes. People can return home the day after the operation and continue the healing process at home. Usually, the treatment period after the operation is about 4 to 6 weeks, during which the person must observe the important things that we will mention below.

When is mastectomy surgery recommended?

Mastectomy is not recommended for all those who get cancer because it is an invasive treatment. This surgery is only recommended in cases where:

Cancer cells have widely involved the entire breast tissue.
The cancer has spread throughout the breast.
The breast is full of cancer cells.

In some cases, it has been seen that some women, as soon as they receive a diagnosis of breast cancer, choose a mastectomy to choose their treatment method and prefer to have the breast tissue completely removed, even if it is not needed and not recommended by the doctor.

Generally, when a doctor wants to recommend a mastectomy, he pays attention to the following factors:

Age of the patient
General health of the patient
Size and volume of cancerous tumor
The spread of cancer cells
Speed of spreading cancer cells
Possible percentage of cancer return
How effective other treatments are (radiotherapy or chemotherapy)
The patient's decision and his concerns about his appearance

Key points that you should pay attention to before mastectomy surgery

Note that before performing a mastectomy, you must talk to a specialist nurse or doctor about the physical and emotional impact this operation may have on you. Also, ask your doctor for advice on bras and tips to consider when using them.

Perhaps, according to the doctor's advice, it is necessary to be treated with chemotherapy and hormone therapy before the operation. Chemotherapy and hormone therapy are used to reduce the size of tumors. The doctor should share with you all the information he has about possible complications and options for breast reconstruction so that you can better cope with the conditions that the operation creates for you.

Dr. Javad Rahmati - specialist in plastic surgery and beauty

How is mastectomy surgery done?

The patient must be completely unconscious during the surgery. In this procedure, the surgeon makes a horizontal or diagonal incision on the breast in order to remove all the damaged tissue from inside the breast, the amount of tissue that is removed depends on the type of mastectomy.

The surgeon usually places one or two drainage tubes in the place where the incision was made to prevent fluid from accumulating in the chest space, so that excess fluid can be removed from them. These tubes may remain in the desired place for a few days after the operation.

Reviewing the types of mastectomy surgery and their differences

There are different types of this surgery, the most important of which we will examine below:

Standard mastectomy

In this type of mastectomy, the doctor removes all the breast tissue and the skin that covers it. This surgery is recommended when the cancer cells have spread and involved the entire breast tissue.

Skin-sparing mastectomy

In this surgery, all the breast tissue including the nipple is removed. In this type of surgery, the skin covering the breast is preserved. Of course, it is possible to reconstruct the breast, which is done by a surgeon.

nipple-sparing mastectomy

This type of surgery is relatively new in which, in addition to preserving the skin of the breast, the nipple is not removed and remains intact. Breast reconstruction in this operation is also performed by a surgeon.

Radical mastectomy

This surgical method is very rare and recommended in very severe cases. In radical mastectomy surgery, in addition to removing all the breast tissue, the surgeon also removes two muscles located behind the breast and the lymph nodes in the armpit.

Modified radical mastectomy

In this type of surgery, doctors act like a radical mastectomy, that is, they remove all the breast tissue and the lymph nodes located in the armpit, but the two large muscles located behind the breast remain in place.

Double mastectomy

When cancer cells involve both breasts, doctors recommend double mastectomy surgery. In this operation, both breasts are removed by the surgeon. In cases where genetic characteristics indicate a high risk of cancer, doctors usually use this method as a preventive treatment. For this reason, this operation is also called preventive mastectomy.

When do lymph nodes need to be removed?

Lymph nodes are small oval shaped balls that are responsible for removing bacteria and other waste materials from the body. If they are affected by cancer cells, they must be removed. Usually, the lymph nodes are removed when a person is undergoing a mastectomy.

In some cases, tests done before surgery may not be able to find cancer cells that are involved with the lymph nodes. For this reason, some surgeons remove some of these lymph nodes for further investigation during the operation.

If the tests done on these lymph nodes show that there are cancer cells in them, the doctor will advise you to either do another operation or be treated with radiotherapy; Of course, in some hospitals, it is possible for the lymph nodes to be tested at the same time as the mastectomy surgery, so that if needed, they can be removed in the same operation and there is no need for a second operation.

What is breast reconstruction and when can it be done?

Breast reconstruction is a procedure to replace the tissue that was removed during mastectomy surgery. This replacement operation is usually performed at the same time as the mastectomy operation (immediate reconstruction), but it is also possible to do it at another date (delayed reconstruction).

Reconstruction is a surgery in which the damaged breast is reshaped. This is done either by using breast implants or by using tissue from another part of the body to create a new breast.

Important tips for recovery at home after mastectomy surgery

Usually, people who undergo mastectomy are discharged from the hospital very soon and spend the post-operative recovery period at home. But if breast reconstruction has been done, it is necessary for the person to be in the hospital and under care for a week.

Following the following points, the healing process will be faster.

· Absolute rest

Usually people feel tired after surgery because of anesthesia and other things. Sufficient and long rest can be very useful for them. These people can recover their lost energy by resting.

· Pain control with painkillers

معمولا پزشکان بعد از انجام عمل جراحی نسخه‌ای از داروهای مسکن را برای بیمار تجویز می‌کنند. These drugs can make it easier to bear the pain, but if the drugs are not enough and have no effect, you should visit the doctor again and consult him. In some cases when the pain is very severe, the cause of the pain must be diagnosed.

· Observance of hygiene to prevent infection

To prevent the wound from getting infected, it is necessary to regularly wash the wound with the help of another person and change the dressing. When you see any discharge from the wound area, you can take a bath.

· Constipation control

Painkillers prescribed for pain may affect a person's bowel movements and lead to constipation. In these cases, the sick person is advised to consume a lot of liquids along with foods that have enough and a lot of fiber. Consuming liquids and fiber-rich foods makes the elimination process easier.

Usually, people who undergo a mastectomy return to their ideal condition within 3 to 6 weeks, but in some cases it has been reported that it may take several months in some rare cases.

Does exercise help in the treatment process?

Ask your doctor when you can start doing light exercise, exercise can not only affect your mood, it can help you get back to health sooner. Arm exercises are usually recommended to expand the full range of motion of the arm and shoulder.

Doing these gentle movements taught by the doctor or nurse can be done after the procedure is done and you feel comfortable. For some people, it is recommended to do physical therapy. Until complete recovery is achieved, it is better to avoid heavy sports.

What should be done with the scar caused by mastectomy surgery?

The scar caused by mastectomy usually covers the entire chest and armpit skin. This scar is usually hidden by the bra cup and is no longer visible. The cut usually fades after time, but it never disappears completely.

If the scar is causing discomfort, it is possible to help it go away with corrective surgery.

Breast tissue reconstruction with the help of other body tissues

What are the side effects of mastectomy?

As you know, all surgeries usually have complications, and mastectomy is no exception. The complications of this surgery are as follows:

problems related to anesthesia
Feeling pain in the shoulder area and stiffness of the arm
Infection and bleeding at the incision site
Feeling itchy, loss of skin in the place where the cut was made and blistering
swelling of lymph nodes and swelling (swelling is usually due to the accumulation of fluid in the arm and armpit.)
Injury of the back, arm and chest nerves
Creation of hard tissue at the cut site

You should be patient when observing any side effects, because after some time all these side effects disappear.

Mastectomy surgery to prevent breast cancer

People who do not have breast cancer, but the probability of getting this type of cancer is very high, can prevent any breast cancer by performing a mastectomy. In preventive mastectomy, both breasts are removed.

Doing this procedure significantly reduces the risk of getting cancer. Prophylactic mastectomy is usually recommended for people who have a strong family history of breast cancer or who have been diagnosed with certain genetic mutations that increase the risk of developing this type of cancer.

Last word

Today, breast cancer has become one of the main concerns among women and men. This disease is the most common type of cancer in women. By performing regular examinations and following medical recommendations, it is possible to prevent this dangerous condition to a large extent.

However, if you or one of your loved ones is diagnosed with breast cancer, know that this is not the end of the road. Fortunately, with the advancement of science, there are many ways for treatment, and in this article, we have described one of the most common ones, which is mastectomy, in detail.

Although this treatment method is not recommended for all patients, it is necessary in some cases, especially to prevent the progression of the disease. Therefore, in this article, we mentioned how to perform this operation, special care and points that should be done before and after the operation.

Remember, getting cancer does not mean the end of life, but recovery is only for those who never give up.

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About Dr. Rahmati

Subspecialist in plastic, cosmetic and reconstructive surgery, associate professor and faculty member of Tehran University of Medical Sciences, member of the Iranian Plastic Surgeons Association