Mastectomy: The Total Removal of Breast

Mastectomy is another type of Breast Cancer Surgery in which total removal of the breast which includes the nipple and areola is affected. This type of surgical procedure is performed by the surgeon to treat the patient who is diagnosed to have breast cancer. In general, a newly diagnosed woman with breast cancer may have the option for their surgical treatment. Surgeons may suggest lumpectomy (partial removal of the breast tissue including the tumor) or mastectomy. However, in mastectomy, chances of recurring breast cancer are lesser compared to lumpectomy, therefore, this type of Breast Cancer Surgery is better than the other one. The only problem for this is the outcome of the surgery wherein the breast is removed. It will affect the self-image of the patient.

Situations where newly diagnosed women are bound to have this type of Breast Cancer Surgery include:

1. After radiologic or imaging examination, the tumor inside the breast is too big. Lumpectomy is the removal of the tumor and the surrounding tissue is not ideal since there will be very less breast tissue will remain after the surgery;
2. If the patient does not want to undergo radiotherapy after the surgery, especially those who are pregnant or lactating women. It will harm the fetus especially when it is still in the process of organogenesis (development of the organ);
3. If she wants to have the assurance that fewer chances for the recurrence of breast cancer after choosing mastectomy as an option.
4. If the tumor found in the breast is more than one quadrant of the breast. Mastectomy is much suggested than lumpectomy.

Before, mastectomy is performed by the surgeon which includes the total removal of the breast tissue as well as the lymph nodes which are found in the armpit area (axilla) through the procedure of lymph node dissection. But for some reasons and innovations, this type of Breast Cancer Surgery have been changed slightly, surgeons decide to remove the first few lymph nodes and draining some of the breast tissue instead of removing all the lymph nodes is better. This procedure has been referred to as sentinel lymph node biopsy. After this, the approach for mastectomy has been changed as well. The surgeon will decide what type of Breast Cancer Surgery will be performed to the patient, the decision will be based on the characteristics of the tumor, the breast tissue, and the surgeon.

The following are different types of Breast Cancer Surgery which are mastectomy:

• Simple or Total Mastectomy. This procedure involves the total removal of breast tissues but leaves the muscle tissues which are found below the breast. This procedure is associated with sentinel lymph node biopsy.
• Traditional Mastectomy. The skin of the breast including the nipple and areola complex is being removed by the surgeon. It is the most common type of mastectomy that is preferred by the cancer patients.
• Skin-Sparing. This type of mastectomy is the same with traditional type. The only difference is the skin that is removed is those that are in the nipple and areola only.
• Nipple-Sparing. The nipple remains but the incisions are made through here and leave the areola intact. The removal of the breast tissue is done and it requires the bigger incision. This often used an S-shape incision.
• Total Skin-Sparing. The breast tissue is removed but the surgeon leaves the skin (including the skin of the areola and the nipple). Usually, the surgeon makes an incision at the external part of the breast or around the areola of the breast.
• Modified Radical Mastectomy. This procedure performed by the surgeon involves the removal of the entire breast tissue including the skin of the areola and nipple. It is associated with the removal of the lymph nodes found in the armpit (axillary nodes). The surgeon usually makes an incision for about 6 to 8 inches. Woman with breast cancer who undergone this type of Breast Cancer Surgery can choose from the immediate or delayed reconstruction of the breast.
• Radical Mastectomy. This procedure involves the entire removal of the breast tissue including the skin of the areola and nipples. The lymph nodes in the armpit area are also removed. The breast muscle which is attached to the chest wall is also removed. This is very common from the previous practices but due to the extent of the surgery plus the innovation of different approaches for Breast Cancer Surgery, this is rarely performed by the surgeon to treat the patient who is diagnosed to have breast cancer.

Due to an innovation of this surgery, mastectomies have been classified into different types which are based on the extent and segment of the breast are being removed. Options will be discussed with the surgeon right after the series of tests that are used before the operation.