Complete information about mastectomy (breast removal)

Surgery or surgery is one of the treatment options for breast cancer. Of the various surgical options, mastectomy is the most commonly recommended by doctors. Then, what is a mastectomy and how is this treatment procedure? Here's the full review.

What is a mastectomy?

Mastectomy is a term for surgical removal of the breast to remove cancer cells. Mastectomy can be performed on one or both breasts.

As quoted from the Mayo Clinic, a mastectomy is a procedure that can remove only part of the breast tissue or all of it, depending on needs.

This treatment procedure can be done alone or in conjunction with other breast cancer treatments, such as radiotherapy and chemotherapy. The determination of the treatment depends on the stage of the breast cancer you are experiencing.

In addition to treating, mastectomy surgery can also be done to prevent breast cancer, especially in women who are at high risk of developing breast cancer. This is called prophylactic mastectomy.

Types of mastectomy surgery

Mastectomy is a surgical procedure that is divided into several types. The doctor will recommend which type needs to be done, depending on your age, general health condition, the size of the breast tumor, and the spread of cancer cells.

Your doctor will also consider your personal reasons for choosing the right treatment procedure. So, don't hesitate to always discuss your considerations and options with your doctor. In general, the various types of mastectomy are:

• Simple

In this procedure, the doctor will remove the entire breast, including the breast tissue, areola, and nipple. The chest wall muscles under the breast and lymph nodes in the armpits are usually not removed.

Breast removal surgery is usually performed for women with the ductal carcinoma in situ (DCIS) type of breast cancer. In addition, this type of surgery can also be performed on women who are at high risk of developing breast cancer as a preventive measure.

• Radical

Radical mastectomy is the most widespread type of breast cancer surgery. In this type, the surgeon will remove the entire breast, including the axillary (armpit) lymph nodes and the chest wall muscles under the breast.

This type of mastectomy can change the shape of the body, so it is rarely recommended. At present, radical mastectomy has been replaced by radical modification as an alternative, because the benefits are the same, but the side effects are less.

However, radical surgery is still possible for large tumors that grow into the chest muscles.

• Radical modification

This procedure combines a total mastectomy with the removal of the lymph nodes under the arm. However, the chest muscles are not removed and are left intact without being touched.

Most patients with invasive breast cancer who decide to have a mastectomy will receive this type of mastectomy. Axillary lymph nodes tend not to be removed to identify whether cancer cells have spread beyond the breast.

• Nipple-sparing mastectomy

• Prophylactic mastectomy

Prophylactic mastectomy is a surgical removal of breast tissue to prevent breast cancer, especially in people who are at high risk for this disease. As for those who are classified as having very high risk factors for breast cancer, namely:

• Women with a family history of breast cancer.
• Positive have the BRCA1 and BRCA2 gene mutations.
• Have a personal history of breast cancer.
• Was diagnosed with lobular carcinoma in situ (LCIS).
• Have had radiation therapy to the chest before age 30 years.
• There is microcalcification of the breast (small deposits of calcium in the breast tissue).

Generally, prophylactic mastectomy is performed as a total mastectomy procedure,skin-sparing mastectomy, ornipple-sparing mastectomy.

Who needs to do a mastectomy?

Women diagnosed with early stage breast cancer can choose between lumpectomy and mastectomy treatment. However, lumpectomy is generally always done with radiotherapy, which is also often referred to as breast-conserving therapy or surgery.

Both are considered equally effective for preventing breast cancer recurrence. However, sometimes the effectiveness and results of a mastectomy are much better. Here are some conditions that are generally recommended for a mastectomy:

• Cannot undergo radiation therapy.
• Prefer breast removal surgery rather than radiation.
• Have had radiation therapy breast treatment.
• I had a lumpectomy but the cancer did not go away.
• Having two or more cancer areas in the same breast that are not close enough to be removed together.
• Tumors measuring more than 5 cm, or even larger than the size of the breast.
• Are pregnant and the effects of radiation will be much more dangerous to the fetus
• Have a genetic factor, such as a mutation in the BRCA gene.
• Have a serious connective tissue disease, such as scleroderma or lupus and are prone to radiation side effects.
• Have an inflammatory type of breast cancer.

Mastectomy side effects

The side effects of this surgery depend on the type of mastectomy you underwent. Here are some of the possible side effects of mastectomy:

• Pain in the area of ​​the surgery.
• Swelling in the operation area.
• Buildup of blood in the wound (hematoma).
• Buildup of clear fluid in the wound (seroma).
• Movement of the arms and shoulders becomes more limited.
• Numbness in the chest or upper arm.
• Nerve pain (neuropathy) in the chest wall, armpit, and / or arm that doesn't go away with time.
• Bleeding and infection in the operated area.
• Swelling (lymphedema) in the arm if a lymph node is also removed.

Consult your doctor again if the side effects are getting worse and don't get better.

What to do before a mastectomy?

Before doing this breast removal surgery, there are several things that need to be done, namely:

• Tell your doctor about medications, vitamins, and supplements that you are currently taking.
• Do not take aspirin, ibuprofen, or blood thinners, such as warfarin a week before surgery.
• Do not eat or drink about 8-12 hours before surgery.

Don't forget to pack clothes, toiletries, and other personal equipment in preparation for hospitalization.

What happens and should be done after mastectomy?

After breast removal surgery (mastectomy), doctors will generally ask you to stay in the hospital for three days, for a period of recovery. During this time, your doctor and other medical team will monitor the progress of your condition.

During this time too, doctors and nurses will teach you gentle exercise to help relax the arms and shoulders on the side of the breast that was performed on the mastectomy. In addition, exercise also reduces the risk of significant scar formation or scarring.

During your stay in the hospital, you will also be placed with a special tube or catheter to collect blood and fluids from the operation area. Ask doctors and nurses how to treat this drain if you still need to use it at home.

While in the hospital, you will also receive information about surgery to recover at home, including how to treat the surgery scar to avoid infections and other complications, such as lymphedema. Therefore, it is best if you recognize signs of infection or lymphedema, so you can go to the hospital immediately if this happens.

In addition to the information above, you may also need to ask your doctor a number of things, such as:

• Time to shower after surgery and how to keep the surgery from becoming infected.
• When you can start wearing bras again.
• When to start using a prosthesis and what type to use if you don't choose to have a breast reconstruction done.
• Allowed use of drugs.
• What activities can and should not be done.

You should also regularly consult a doctor after this breast removal surgery. This is so that doctors can continue to monitor your condition.

Mastectomy surgery recovery at home

Generally, surgical recovery can take up to several weeks. However, the recovery will take longer if you do the breast reconstruction at once.

How to recover after breast removal surgery can be different for each person. To restore your body condition at home after a mastectomy, the ways you can do are:

• Rest.
• Routinely take the medicine given by the doctor.
• Eating foods for breast cancer.
• Be careful when cleaning yourself. Use the washcloth until the doctor removes your drain or stitches.
• Exercise regularly or move the body, as taught by doctors and nurses.