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RADICAL MASTECTOMY

What is radical mastectomy?

Radical Mastectomy is a surgery performed to treat cancers of the breast. This surgical intervention involves removal of the affected breast, underlying tissues chest muscles (pectoralis major and pectoralis minor) and lymph nodes present in the axilla or under-arm.

It is worthwhile to note that the first radical mastectomy was done in the year 1882 by Dr William Stuart Halsted. It became a time-tested procedure and 90% of the women suffering from breast cancer underwent this surgery until the late 70’s. There have been advancements in the procedure following extensive research in the field of breast cancers and many modifications have been incorporated in the procedure. The surgical procedures now performed is less extensive compared to the original version and has better effects. Mainly three types of Mastectomies are performed widely by oncologists treating cancers:

1. Total (simple) mastectomy : Oncologists consider this the best procedure for women with large and multiple areas of ductal carcinoma in situ (DCIS). The breast tissue only is targeted

  • The surgeon and his team remove the entire breast.
  • The surgeon may not perform axillary lymph node dissection (removal of lymph nodes in the underarm area). In certain cases, however, lymph nodes are occasionally removed as they happen to be located within the breast tissue taken during surgery.
  • No muscles are removed from underneath the breast.

2. Modified radical mastectomy : This procedure involves the removal of breast tissue and lymph nodes as well. It is the best procedure for invasive breast cancers.

3. Partial mastectomy : In this procedure only the cancerous portion of the breast tissue is removed, sometimes along with adjoining normal tissues. Lumpectomy can be classified as partial mastectomy, but less of tissue is removed under lumpectomy compared to the traditional form of partial mastectomy. In lumpectomy most of the breast lies untouched or is preserved and is often termed as breast conservation surgery or technique.

 

Why is radical mastectomy performed ?

The focal point of performing radical mastectomy is to arrest breast cancer. Radical mastectomy may be accompanied with radiotherapy or chemotherapy to achieve better results as per the patient’s condition. The surgery performed now is termed as modified radical mastectomy or MRM. It is very effective in treating early stage breast cancers. It reduces the risk of malignancy, but may not eliminate it.

Before the Procedure: The oncologist advises medical tests such as x-rays, CT-Scan and other biochemistry reports to study and understand the state of malignancy present. The doctor takes into consideration size and location of the tumour, the number of tumours present and the extent of their malignancy, other general conditions such as age, family history or any other complications, before posting the patient for surgery. A week prior to the surgery blood thinning medications such as aspirin and painkillers like naproxen have to be withdrawn. The patient will be prepared for the surgery by the caregivers in the hospital.

The Procedure: Firstly before the surgery the patient’s blood will be cross-matched to be prepared for any transfusion during the surgery. The oncologist makes an incision at the accurate area after making the relevant marks on how the surgery should be done, based on where the tumour is lodged the surgeon may go in for partial mastectomy, a total or MRM procedure. After the tumour is extracted the surgeon stitches up the incision after which dressing is done. The surgery may take more than 2 hours.

After the surgery: The patient is cared for in the intensive care unit for the first 48 hours, once condition has improved , he is posted to a room. The stay in the hospital will be about 1 week to 10 days. The patient will be encouraged to walk and do his routine activities. Antibiotics are given for the sutures to heal faster. The treatment may be accompanied by radiotherapy and chemotherapy as per the patient’s condition. Any fluid retention near the surgical area will be drained by needle aspiration. Strenuous activity should be avoided during the first three months. A physiotherapist required to assist you to regain your shoulder motion.

Complications or risks :

Modified radical mastectomy is the most preferred surgery to address breast cancers. It has its own inherent risks like:

  • Piercing pain, shoulder stiffness or pain, which disappears gradually after moderate exercises as suggested by the physiotherapist
  • Lymphedema or swelling on the side where surgery is done.
  • In some instances damage to the nerves in the surgical area may occur
  • Risk of infection at the surgical area

Despite, the inherent risks, radical mastectomy are a proven procedure to attack the progression of breast cancer. Many women have benefited from the same.

 

Why KIMS ?

KIMS has been the most trusted cancer care provider for many patients. Our surgeons have gained mastery in the subject of mastectomy. Very fragile and critical cases were handled with utmost care and our doctors were able to achieve positive outcomes in almost all the cases. We have good base of satisfied patients.

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