Mastectomy is a surgical procedure for the removal of one or both breasts, which in most cases is indicated for people diagnosed with cancer, and may be partial, when only part of the tissue is removed, in total, when the breast is removed completely or even radically when, in addition to the breast, neighboring muscles and tissues that may have been affected by the tumor are removed.
In addition, mastectomy can also be preventive, to reduce the risk of developing breast cancer in women, or it may have an aesthetic purpose, in the case of surgery with masculinizing intent, for example.
Mastectomy may be done when
For example, it is important for a woman to see the gynecologist once a year for preventive evaluations, or when symptoms that may indicate the presence of a breast tumor, such as the presence of a lump, redness, or the presence of breast secretions, learn to recognize the main symptoms of breast cancer.
For each goal to be achieved with breast removal, a type of surgery can be performed, which is chosen by the mastologist or plastic surgeon, depending on each case. The main types are:
Also known as a quadnectomy or sectorectomy, it is a surgical procedure to remove a benign nodule or tumor, with some of the surrounding tissue, without the need to fully train the breast.
In this surgery, certain lymph nodes near the breast may or may not be removed to avoid the risk of the nodule returning.
During a total mastectomy, the mammary glands are completely removed, in addition to the skin, areola, and nipple. It is best indicated in the case of a small, early and well-located tumor, without the risk of spreading to the surrounding areas.
In this case, it is also possible to remove the lymph nodes in the area below the bone, to reduce the risk of recurrence or spread of the tumor.
In radical mastectomy, in addition to the removal of the entire breast, the muscles under it and the nodes of the axillary area are also removed, being indicated for cancers at risk of spread.
There are variants of this surgery, known as Patey’s modified radical mastectomy, in which Madden’s major pectoral muscle, or modified radical mastectomy, is maintained when the major and minor pectoral muscles are preserved.
Preventive mastectomy is done to prevent the development of cancer and is only suitable for women at very high risk of developing the disease, such as those with a significant family history or who have genetic changes that can cause cancer, such as BRCA1 and BRCA2. Know when to do a genetic test for breast cancer.
This surgery is performed in the same way as total or radical mastectomies, removing the entire breast, nearby lymph nodes, and, in some cases, surrounding muscles. Bilateral surgery is usually performed, as in these cases the risk of developing cancer is similar in both breasts.
Male or masculinizing mastectomy is a type of plastic surgery that is performed to give a woman’s chest a masculine appearance. Thus, in this surgery the breast is removed, which can be performed by different techniques, decided by the plastic surgeon, depending on the size and type of breasts of each woman.
Mastectomy can also be performed in men with breast cancer, which occurs less often, and surgeries are performed in the same way as in women, although men have far fewer glands.
There are also cosmetic breast surgeries known as mammoplasty, which can be used to reduce, increase or improve the appearance of the breasts. Find out what options are for plastic breast surgery.
Breast removal is surgery that lasts approximately 60 to 90 minutes, with spinal or general anesthesia.
Recovery after surgery is rapid and can take 1 to 2 days of hospitalization, depending on the type of surgery and whether it has been bilateral or unilateral.
A drain may be left, so that the secretion produced in the first days after the procedure is removed, which must be attached and well adapted to the clothing so that it does not accidentally throw away. This drainage should be emptied approximately 2 times a day, noting the amount drained to inform the doctor during the return visit.
In addition, some recommendations to follow during the postoperative period are:
In surgeries with lymph node removal, the circulation of the corresponding arm may be compromised and become more sensitive, it is important to protect it from injury, burns and avoid excessive stress.
After the procedure, it is always important that treatment continues with physical therapy, which will help improve arm movement, circulation and reduce contractures caused by healing. See more details about recovery after breast removal.
After any type of mastectomy, breast reconstruction surgery may be needed to restore the natural shape of the breasts. This can be done immediately after the procedure or in stages, with a gradual correction of the area, but in many cases of cancer, it may be necessary to wait a while for a complete healing or after examinations to confirm the complete elimination of the malignant cells.
Find out how breast reconstruction is done.