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Encyclopedia > Mastectomy

In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. It is also the medical procedure carried out to remove Breast Cancer (tissue) in males. Alternatively, certain patients can choose to have a wide local excision (also called a lumpectomy), an operation in which a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. Both mastectomy and lumpectomy are what are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy. medicines, see medication and pharmacology. ... A pregnant womans breasts. ... Breast cancer is cancer of breast tissue. ... Prophylaxis refers to any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease. ... This article or section does not cite its references or sources. ... Lumpectomy is a common surgical procedure designed to remove a discreet lump (usually a tumour, benign or otherwise) from an affected womans breast. ...

Traditionally, in the case of breast cancer, the whole breast was removed. Often the mastectomy was performed during the same operation in which the biopsy was taken that confirmed the diagnosis. Nowadays the decision to do the mastectomy is usually based on the earlier performed biopsy. Also there is a trend to a more conservative approach to breast cancer. Practice has changed, on the one hand, due to improvements in radiotherapy and adjuvant treatment (e.g. chemotherapy or hormonal therapy) which mean a wider excision no longer makes local recurrence less likely, and on the other hand a recognition that breast cancer metastasizes early. Radical excision will not prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis and operation. Brain biopsy A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ... Radiation therapy (or radiotherapy) is the medical use of ionizing radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ... Chemotherapy is the use of chemical substances to treat disease. ... This article needs cleanup. ...

Mastectomy rates vary tremendously world-wide, as was documented by the 2004 Intergroup Exemestane Study[1], an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries. The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.


Mastectomy Indications

Despite the increased ability to offer breast-conservation techniques to patients with breast cancer, there exist certain groups who may be better served by traditional mastectomy procedures including:

  • women who have already had radiation therapy to the affected breast
  • women with 2 or more areas of cancer in the same breast that are too far apart to be removed through 1 surgical incision, while keeping the appearance of the breast satisfactory
  • women whose initial lumpectomy along with (one or more) re-excisions has not completely removed the cancer
  • women with certain serious connective tissue diseases such as scleroderma, which make them especially sensitive to the side effects of radiation therapy
  • pregnant women who would require radiation while still pregnant (risking harm to the fetus)
  • women with a tumor larger than 5 cm (2 inches) that doesn't shrink very much with neoadjuvant chemotherapy
  • women with a cancer that is large relative to her breast size
  • male breast cancer patients

Types of Mastectomy

There are a variety of types of mastectomy in use, and the type that a patient decides to undergo (or whether he or she will decide instead to have a lumpectomy) depends on factors such as size, location, and behavior of the tumor (if there is one), whether or not the surgery is prophylactic, and whether or not the patient intends to undergo reconstructive surgery.

  • Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the would be expected to drain into--is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less then 20-30 ml per day. illustration
  • Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). illustration
  • Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoral tissue behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall.illustration
  • Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). The increased amount of skin preserved as compared to traditional mastecomy resections serves to facilitate breast reconstruction procedures. Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy. illustration
  • Quandrantectomy, or partial mastectomy: Like a lumpectomy, this is considered a form of breast conservation therapy. However, a quadrantectomy involves removal of more breast tissue than a lumpectomy--up to a quarter of the breast may be removed, whereas a lumpectomy removes only the tumor and a margin of surrounding tissue.
  • Subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. This procedure was historically done only prophylactically or with mastecomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position [PMID 12832974] [PMID 17269590] [PMID 17084333]

The sentinel lymph node is the hypothetical first lymph node reached by metastasizing cancer cells from a tumor. ...

See also

A pregnant womans breasts. ... Breast cancer is cancer of breast tissue. ... A breast prosthesis is a silicone breast form intended to replace a lost breast. ... Breast reconstruction is the rebuilding of a breast, usually in women. ... Sexual reassignment surgery from female to male includes surgical procedures which will reshape a female body into a body with a male appearance. ...

External links

  Results from FactBites:
Mastectomy - Wikipedia, the free encyclopedia (180 words)
In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely.
Mastectomy is usually done to combat breast cancer; in some cases, women believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it.
Often the mastectomy was performed during the same operation in which the biopsy was taken that confirmed the diagnosis.
MedlinePlus Medical Encyclopedia: Mastectomy (1949 words)
A mastectomy is the surgical removal of the entire breast, usually to treat serious breast disease, such as breast cancer.
Breast conservation surgery, also known as lumpectomy or partial mastectomy, is usually followed by radiation therapy to the breast.
Preventive, or prophylactic mastectomy is the surgical removal of one or both breasts that do not contain cancer or DCIS, in an effort to prevent or reduce the risk of breast cancer.
  More results at FactBites »



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