The surgical removal of all of the breast, usually performed to treat breast cancer. Mastectomy may be used for extensive breast cancer or for multiple cancerous tumours. For smaller cancers, lumpectomy or quadrantectomy may be appropriate.
A mastectomy involves the removal of all of the breast tissue and usually some or all of the lymph nodes in the armpit. Cells from the lymph nodes are examined to determine whether cancerous cells may have spread. The operation is performed under general anaesthesia and usually requires a stay in hospital of several days. Plastic surgery to reconstruct the breast may be carried out at the same time as the mastectomy or at a later time (see mammoplasty).
Treatment with radiotherapy is often given after surgery, especially if the cancer has spread to lymph nodes. It usually starts a month after surgery and is continued for 6 weeks. Drug treatment with tamoxifen or chemotherapy may also be given.
A surgical operation to remove part or all of the breast (see BREASTS). It is usually done to treat cancer, when it is commonly followed by CHEMOTHERAPY or RADIOTHERAPY (see BREASTS, DISEASES OF). There are four types of mastectomy: lumpectomy, quandrantectomy, subcutaneous mastectomy and total mastectomy. The choice of operation depends upon several factors, including the site and nature of the tumour and the patient’s age and health. Traditionally, radical mastectomy was used to treat breast cancer; in the past three decades, however, surgeons and oncologists have become more selective in their treatment of the disease, bringing the patient into the decision-making on the best course of action. Lumpectomy is done where there is a discrete lump less than 2 cm in diameter with no evidence of glandular spread. A small lump (2–5 cm) with limited spread to the glands may be removed by quadrantectomy or subcutaneous mastectomy (which preserves the nipple and much of the skin, so producing a better cosmetic e?ect). Lumps bigger than 5 cm and ?xed to the underlying tissues require total mastectomy in which the breast tissue, skin and some fat are dissected down to the chest muscles and removed. In addition, the tail of the breast tissue and regional lymph glands are removed. In all types of mastectomy, surgeons endeavour to produce as good a cosmetic result as possible, subject to the adequate removal of suspect tissue and glands.
Breast reconstructive surgery (MAMMOPLASTY) may be done at the same time as the mastectomy – the preferred option – or, if that is not feasible, at a later date. Where the whole breast has been excised, some form of arti?cial breast (prosthesis) will be provided. This may be an external prosthesis ?tted into a specially made brassiere, or an internal implant – perhaps a silicone bag, though there has been controversy over the safety of this device. Reconstructive techniques involving the transfer of skin and muscle from nearby areas are also being developed. Post-operatively, patients can obtain advice from Breast Cancer Care.
n. surgical removal of a breast. Simple mastectomy, performed for extensive but not necessarily invasive tumours, involves simple removal of the breast; the skin and if possible the nipple may be retained and a prosthesis (see breast implant) may be inserted under the skin to give the appearance of normality. When breast cancer has spread to involve the lymph nodes, radical mastectomy may be performed. This classically involves removal of the breast with the skin and underlying pectoral muscles together with all the lymphatic tissue of the armpit. This treatment may be followed up with radiotherapy and/or chemotherapy. In modern surgical practice a modified radical mastectomy, preserving the pectoral muscles, is more usual than the classical technique. See also lumpectomy.
Health Encyclopedia