Mastectomy Procedure Guide

Mastectomy Procedure Guide

A mastectomy is a surgical procedure to remove all or part of the breast tissue, typically performed to treat or prevent breast cancer. Depending on the type and purpose, it may involve removing one or both breasts and surrounding tissues such as lymph nodes or chest muscles.

Procedure Classification

Surgery – Mastectomy is classified as a therapeutic surgical procedure, primarily performed to treat or reduce the risk of breast cancer. It can also be done for individuals with high genetic risk (e.g., BRCA mutation).

Mastectomy Statistics

• In the UK, over 18,000 mastectomies are performed annually.
• Breast cancer is the most common cancer in women, and approximately 30% of these patients will undergo a mastectomy as part of their treatment.
• Preventive mastectomy reduces the risk of breast cancer by up to 90% in high-risk patients.

Types of Mastectomy

1. Total (Simple) Mastectomy: Removes the entire breast but not lymph nodes.
2. Modified Radical Mastectomy: Removes the entire breast and some lymph nodes.
3. Radical Mastectomy: Removes the breast, lymph nodes, and chest muscles. Rarely used today.
4. Skin-Sparing Mastectomy: Removes the breast tissue but preserves most of the skin. Often used when immediate reconstruction is planned.
5. Nipple-Sparing Mastectomy: Preserves the nipple and surrounding skin, with breast tissue removed.

Anatomy and Physiology

A mastectomy is performed on breast tissue, which includes:

• Breast tissue itself (glandular and fatty tissue)
• Nipple and areola (depending on the type)
• Axillary lymph nodes (in some cases)
• Chest wall muscles (in radical mastectomy)

Who Needs Mastectomy?

Mastectomy may be necessary for:

• People with breast cancer at an early or advanced stage.
• Individuals with ductal carcinoma in situ (DCIS) or extensive pre-cancerous cells.
• People at high genetic risk, such as those with BRCA1 or BRCA2 mutations.
• Patients who do not respond to other treatments like chemotherapy or radiation.

Costs & Coverage

In the UK, a mastectomy is typically covered by the NHS for patients with a medical need.

• Private sector costs range from £5,000 to £10,000, depending on complexity and hospital.
• Breast reconstruction is often included in NHS care for eligible patients.

Health Symptoms & Illnesses

Mastectomy is primarily associated with:

• Breast cancer
• Ductal carcinoma in situ (DCIS)
• Recurrent breast cancer
• Lobular carcinoma in situ (LCIS) (in some cases)
• BRCA mutation for preventive measures

Health Professionals

• Breast Surgeon: Performs the mastectomy.
• Oncologist: Specializes in cancer treatment and management.
• Plastic Surgeon: Performs breast reconstruction.
• Nurse Specialist: Provides care, support, and education.
• Physiotherapist: Helps with recovery and mobility after surgery.

Questions to Ask

• What type of mastectomy do I need?
• Will I need breast reconstruction?
• How long will the recovery take?
• What are the risks and complications?
• How will this affect my daily life?
• Do I need lymph node removal?
• Will I need additional treatments?

Mastectomy Process

Before the Procedure:

• Consultation with your surgeon and oncologist
• Imaging tests (e.g., mammogram, MRI)
• Discussion about breast reconstruction options

During the Procedure:

• General anesthesia is used.
• The surgeon removes the affected breast tissue and lymph nodes, if needed.
• Reconstruction may be performed simultaneously or later.

After the Procedure:

• Hospital stay of 1–2 days (longer for complex cases)
• Drainage tubes may be placed to prevent fluid buildup.
• Pain management and wound care instructions provided.

Recovery Process:

• Full recovery takes 4–6 weeks, depending on the type.
• Physical therapy may be required to restore shoulder movement and prevent stiffness.
• Regular follow-up appointments.

Preparation

Nutrition Dos and Don’ts

• Dos: Focus on protein-rich foods, fresh fruits, and vegetables. Stay hydrated.
• Don’ts: Avoid alcohol, high-sugar, and processed foods leading up to surgery.

Lifestyle Dos and Don’ts

• Dos: Get plenty of rest, follow your doctor’s exercise advice, and quit smoking.
• Don’ts: Avoid heavy lifting and strenuous activities for several weeks.

Results

• Pathology results are typically available within 7–14 days.
• They will show whether cancer has spread and guide further treatment.
• Discuss results thoroughly with your oncologist.

Diagnosis

Mastectomy can provide a definitive diagnosis and staging for breast cancer through tissue analysis.

Risks and Benefits

Risks:

• Infection, bleeding, and scarring
• Loss of sensation in the chest area
• Lymphedema (swelling due to lymph node removal)
• Emotional impact

Benefits:

• Effective cancer treatment or prevention
• Reduced cancer recurrence risk
• Improved survival rates for high-risk individuals

Alternatives

• Lumpectomy (breast-conserving surgery)
• Radiation therapy
• Hormone therapy
• Chemotherapy

Health Monitoring

After a mastectomy, professionals monitor for:

• Signs of infection
• Lymphedema development
• Cancer recurrence
• Emotional well-being

Clinical Products

1. Compression Garments: Helps manage swelling and lymphedema.
2. Drainage Supplies: For post-surgical fluid management.
3. Pain Medication: Prescribed for managing discomfort.
4. Scar Creams: Helps minimize scarring.
5. Breast Prosthesis: For patients opting out of reconstruction.

Services

1. Breast Cancer Nurse Specialist: Provides ongoing support and care.
2. Counseling Services: Helps patients cope emotionally.
3. Rehabilitation Services: Focuses on physical recovery and mobility.
4. Insurance Support: Assists with claims and coverage questions.
5. Nutritionists: Offers guidance on healthy eating during recovery.

Frequently Asked Questions

1. Is mastectomy painful?
   Pain is managed with medication, but some discomfort is expected.
2. How long does the surgery take?
   About 2–3 hours.
3. Will I need chemotherapy after a mastectomy?
   It depends on the cancer stage and type.
4. Can I drive after the surgery?
   Not for at least two weeks or until your doctor approves.
5. Will I lose feeling in my chest?
   Numbness is common and may be permanent.
6. What are the chances of cancer coming back?
   Reduced but not eliminated. Regular monitoring is essential.
7. Can I breastfeed after a mastectomy?
   Not from the affected breast.
8. How do I choose between mastectomy and lumpectomy?
   Your doctor will help based on your cancer type and personal preference.
9. Is breast reconstruction necessary?
   No, it’s a personal choice.
10. Can men have a mastectomy?
    Yes, for male breast cancer or gynecomastia.