What is a Mastectomy?

 

A mastectomy is a surgical procedure to treat breast cancer along with chemotherapy and radiotherapy. It involves removing the whole breast or sometimes nearby tissues as well. [1]

 

The decision to perform a Mastectomy depends on the following parameters:

• Patient's age
• Overall health
• Tumor size
• Menstrual cycle
• Tumor stage
• Tumor grade

There are different types of mastectomy and which one to be performed depends on the above-mentioned parameters.

 

Generally, Mastectomy is safe and effective. But just like all surgical interventions, it can have risks.  Such as bleeding, infection, lymphedema (arm swelling), seromas (pockets of fluid under the incision), and risk from general anesthesia.

 

 

 

What are the Indications of a Mastectomy?

 

A mastectomy can be performed to remove the diseased breast or prophylactically in cases of people who have a genetic tendency for breast cancer.

 

A mastectomy is indicated in the following types of breast cancer: [3]

 

• Non-invasive breast carcinoma
• Early Stage breast cancer (stage I and II)
• Locally advanced stage III breast cancer after chemotherapy
• Locally recurrent breast cancer
• Paget's disease of the breast
• Inflammatory breast cancer after chemotherapy
• More than one tumor in separate areas of the breast
• Widespread malignant calcium deposits throughout the breast that appear to be cancer after the breast biopsy
• Recurrent breast cancer that does not go away with radiation and lumpectomy
• The enormous size of the tumor relative to the size of the breast
• To proactively prevent breast cancer, surgeons perform the mastectomy

 

A mastectomy can be unilateral or bilateral depending if one or both breasts are being removed.

 

 

 

What are the Causes of a Mastectomy?

 

The causes of mastectomy can be breast cancer and breast lumps. Genetic mutations are responsible for causing breast cancer. Patients with deleterious BRCA genetic mutation are at increased risk of breast cancer. A BRCA1 or BRCA2 mutation carrier has a lifetime risk of breast cancer as high as 80 to 85% [4].

The genetic mutation in p53 and PTEN genes are also the causative agents for breast cancer.

 

 

 

What are the Types of a Mastectomy?

 

Following are the types of mastectomy [5]:

 

• Total (simple) mastectomy: In a simple mastectomy, the whole breast is removed including the nipple, areola, and the surrounding skin.

 

• Modified radical mastectomy (MRM): in MRM, breast tissue, nipple, areola, surrounding skin, lining overlying the chest muscles, and level-i and level-ii axillary lymph nodes are also removed.

 

• Radical mastectomy: Radical mastectomy is the most intensive form of mastectomy.  The procedure removes the whole breast, overlying chest muscles, and levels I, II, and III axillary lymph nodes.

 

• Nipple-sparing mastectomy: The other name for Nipple-sparing mastectomy is subcutaneous mastectomy.  This type removes the breast tissue and tumors.  But the nipple and areola are preserved.

 

 

 

References:

1. https://www.webmd.com/breast-cancer/mastectomy
2. https://medlineplus.gov/mastectomy.html
3. https://www.mayoclinic.org/tests-procedures/mastectomy/about/pac-20394670
4. https://www.ncbi.nlm.nih.gov/books/NBK538212/
5. https://www.medicinenet.com/radical_mastectomy_vs_modified_radical_mastectomy/article.htm

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