Mastectomy is primarily used as a treatment for breast cancer. In very rare cases, it is also employed as a surgical option for some long-standing, uncontrollable, or recurrent breast diseases.
Historically, radical mastectomy, an extensive procedure involving the complete removal of breast tissue, axillary lymph nodes, and the pectoral muscles beneath the breast tissue, was the standard approach for breast cancer treatment. However, this procedure is no longer performed today. Advancements in technology and surgical techniques, along with a better understanding of breast cancer, have led to the replacement of older surgical methods with contemporary approaches.
Modern mastectomy techniques involve less invasive procedures, preservation of the breast skin when possible, and options for breast reconstruction either simultaneously with the mastectomy or at a later time. This enables patients to have a choice in restoring the appearance of their breasts following the removal of breast tissue.
Mastectomy can be performed on a single breast or both breasts. Following mastectomy, reconstruction of the breast can be done either simultaneously with the surgery or at a later time.
Mastectomy surgery is typically performed under general anesthesia and lasts approximately 1-2 hours. The procedure is considered to be comfortable from a surgical perspective, and in the post-operative period, it aims to maintain pain at a tolerable level for the patient. After the surgery, patients can usually mobilize early, eat, take a shower shortly, and are often discharged within 1-2 days.
There are various mastectomy methods available, and the choice of method depends on factors such as tumor size, type, and location. Here are some common mastectomy techniques:
Segmental Mastectomy: Also known as partial mastectomy or lumpectomy, this method involves removing the tumor and a margin of surrounding tissue, preserving most of the breast.
Breast-Conserving Surgery: This approach aims to conserve as much of the breast as possible while removing the tumor. It is often followed by radiation therapy.
Radical Mastectomy: This was a more extensive procedure that involved the removal of breast tissue, axillary lymph nodes, and the pectoral muscles beneath the breast. It is rarely performed today.
Simple Mastectomy: A relatively straightforward procedure that removes the entire breast but spares the axillary lymph nodes and underlying muscles.
Bilateral mastectomy involves the removal of breast tissue in both breasts, and it is typically performed when cancer is detected in both breasts or when a patient has a high risk of developing breast cancer.
Modified radical mastectomy (MRM) is a procedure in which the breast tissue and axillary lymph nodes are removed, but the chest wall muscles are preserved, making it a more widely accepted approach in current practice.
Breast-conserving mastectomy is a common approach where cancerous tissue is removed while sparing the remaining breast tissue, skin, and nipple.
Skin-sparing mastectomy involves the removal of breast tissue, often used for breast reconstruction, while preserving the breast skin and nipple area.
The choice of mastectomy technique is tailored to the patient's individual circumstances, taking into account tumor characteristics, the extent of disease, and the patient's overall health.
Segmental mastektomi, meme kanseri boyutunun küçük olduğu durumlarda meme kanseri ile birlikte etraf sağlam doku ile birlikte genişçe çıkarıldığı bir mastektomi türüdür.
Segmental Mastectomy Segmental mastectomy is a type of mastectomy performed when the size of the breast cancer is relatively small. It involves the removal of the breast cancer along with a significant amount of surrounding healthy tissue.
Conservative Mastectomy Surgery Conservative mastectomy surgery is performed with the goal of preserving breast tissue to provide the patient with a better cosmetic outcome. The success of this surgery depends on the size of the breast and the size of the tumor. The breast size should be suitable, and the tumor size should be small. After this surgery, the patient may require radiotherapy, so it's important that the patient can access a radiotherapy center. Most importantly, the patient must be willing to undergo this treatment.
Radical Mastectomy Radical mastectomy is a surgical procedure in which breast tissue is removed along with the axillary lymph nodes and the chest muscles. However, this surgical technique is no longer used today. With a better understanding of breast tumors, advancements in technology, and early detection through breast cancer screening methods, radical mastectomy has been replaced by newer surgical techniques.
Simple Mastectomy Simple mastectomy, also known as total mastectomy, is a surgical procedure in which only the breast tissue is removed, while the axillary lymph nodes and chest muscles are preserved.
A mastectomy surgery typically lasts around 1-2 hours, depending on the size of the breast. During the surgery, patients usually do not require a blood transfusion. The hospital stay after the surgery is usually 1-2 days. Patients can eat and mobilize about 5 hours after the surgery, and they are often discharged from the hospital on the second day following the procedure.
Mastectomy surgery does not have specific inherent risks, but like all surgeries, it carries acceptable, known risks that are necessary for the procedure.
Breast reconstruction after mastectomy is a commonly used method in recent years. The aim here is to completely remove the breast tissue and provide the patient with a good cosmetic result. For this purpose, in suitable cases, the breast tissue is completely removed. Breast reconstruction is performed using simultaneous prostheses, either with or without nipple preservation, to reshape the breast tissue.
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Prof. Dr. Sezai AydınGeneral Surgery Turkey
PROF. DR. SEZAI AYDIN
