Mastectomy is used today to treat breast cancer followed by radiation therapy and anticancer drugs. The size of the tumor, location, how much the cancer has spread, the age of patient, and the health of patient determines the amount of breast tissue that is removed.
Types of mastectomy are:
Lumpectomy (only cancerous tissue removed)
Quadrantectomy (one quadrant of breast is removed)
Simple mastectomy (removing affected breast and some of underarm lymph nodes)
Modified radical mastectomy (removal of breast, chest muscle,all chest and underarm nodes)
Until late in the sixties only the modified radical mastectomy was done. Today surgeons more often recommend the lumpectomy in which only canererous tissue is removed. or quadrantectomy. The simple mastectomy is done so they can leave plenty of underlying skin so the breast can be reconstructed.
General anesthesia is given and the procedure begins. for lumpectomy and quadrantectomy an incision is made over breast lump and it is cut free and removed with or without surrounding tissue. Foe subcutaneous mastectomy a incision is made along the breast closest to the tumor, For extensive operations the incision extends from armpit to to include the whole breast. The underlying tissue is cut free and removed. A drainage tube is inserted in all mastectomy surgeries. The skin is closed with stitches or clips which is removed in about a week. A skin draft may be needed.
The recovery period for lumpectomy and quadrantectomy is two weeks with release from hospital in around two days. If other more extensive surgeries are done the hospital stay may be several days with drainage tube removed in two or three days. Painkiller will be given for pain.
The outlook is very good for lumpectomy and quadrantectomy and there will be noticeable scaring. Infection is very uncommon with these two surgeries. Scars are more extensive after the more intense surgeries but fade as years go on.
Complications after the more extensive surgeries include lymphedema where fluid accumulates under the skin or stiffness of the arm and shoulder. A temporary prosthesis may be worn until chest scars heal. After healing is complete a more permanent prosthesis can be worn. Sometimes a plastic silicone implant can be inserted either during mastectomy or in a later operation.