Breast Removal (Mastectomy)

Breast removal surgery or ‘Mastectomy’ – the medical term for this procedure – is where part, or all of the breast tissue is removed. In some cases, this not only includes the removal of the breast tissue, but may include the removal of the nipple, areola and glandular tissue.

Why have Breast Removal Surgery (Mastectomy)?

This type of operation would only take place as a treatment for breast cancer. This form of treatment is not only available for women it is also available for men. A mastectomy is usually performed on an individual to not only get rid of already cancerous cells; it is also used as a preventative measure to reduce the chance of cancer in the chest area.

There are many kinds of mastectomies. A ‘Subcutaneous Mastectomy’ is where the surgeon removes the whole breast under the skin, however leaves the nipple and areola. This means that the breast can be rebuilt and the individual can have almost natural looking breasts, apart from a few scars.

A ‘Total Mastectomy’ or ‘Simple Mastectomy’ is where the surgeon removes all of the breast tissue, including the glandular tissue and fatty tissue. This mastectomy also includes the removal of the nipple and areola. In addition, the surgeon may feel that it is necessary to take a biopsy of the lymph nodes around the breast area. This particular surgery occurs with some rare cancers, where both of the breasts need to be removed in order to prevent any further cancerous cells from spreading.

A ‘Radical Mastectomy’ is one of the most invasive mastectomies and it is rarely done unless absolutely necessary. This kind of mastectomy is where not only the entire breast tissue, fatty tissue, skin, nipple and areola are removed but the entire chest muscle is taken away, including the lymph nodes underneath the arm. It is an extremely radical choice, hence the name.

A ‘Modified Radical Mastectomy’ is where the surgeon removes the breast but also takes out the lymph nodes, which are found underneath the arm. Once the mastectomy is performed, it can leave very little skin to seal the area so sometimes it may be necessary to take skin from other areas of the body. The surgeon will look for areas that have excess skin, such as the thigh or bottom area. Once the skin has been removed it can then be used to help seal the breast properly.

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The Procedure
After the surgery it is quite common for the surgeon to insert a couple of plastic tubes into certain areas of the breast, in order to help the drainage of excess fluid. If this fluid builds up this can cause pain, but it can also create cysts that might need a further surgical procedure to aspirate them. As this is another invasive surgery, your surgeon will actively avoid putting you through more pain and potential problems.
A mastectomy is an extremely difficult procedure to go through as some women feel that the surgeon has not only removed their breast but also their womanhood. Your surgeon may suggest that it is necessary to speak to a counsellor before and after having this type of surgery, as the individual may feel very disconnected with real life.

After a Mastectomy, a patient may even find it hard to accept what has happened to them. This is why seeking professional help is necessary to bring the individual back to real life and help to cope with and accept what has happened. It can be a devastating experience not only for the woman going through the procedure, but also for their families. Some surgeons feel it is necessary to have a counsellor speak to the family in order to help them accept and assist each other with the recovery process.

Risks and Complications
Generally, modern day surgery is considered safe.

Unfortunately like many other breast surgeries, there are always risks and complications that occur, especially with the more invasive kinds of mastectomies. Risks that come with a general anaesthetic include; suppressed breathing, lowered blood pressure, and the risk of heart attack, heart failure and even death. These will be discussed with the individual prior to the operation. Approximately one-third of patients who receive an anaesthetic during surgery will experience “anaesthesia sickness” or post-operative nausea and vomiting (POVN).

The mastectomy itself has a lot of risks and complications attached to it. These include infection of the scar area, keloid scaring which is where the scar becomes raised, red and sore.

A more serious complication associated with a mastectomy is PMPS, which stands for ‘Post-Mastectomy-Pain-Syndrome’ and according to statistics, between 20 to 60% of women who have the surgery, suffer with this problem. Symptoms for this include; tingling down their side and down their arm where the surgery took place, itching and pain in the shoulder and armpit area and finally, pain around the general area of the surgery resulting in the need for pain treatment.

Lymph node complications are also possible. When the lymph nodes are removed from around the chest and armpit area this could leave the arm in real trouble. The lymphatic system drains the toxins from the blood stream and so without them, this could leave your arm open to serious issues.

Frequently Asked Questions (FAQ)

Q. Does my insurance cover the cost for my mastectomy?

A. The majority of insurance companies will cover the costs of your mastectomy and with this, they then must also cover the costs for any reconstructive surgeries you may have in the future. Of course it depends on the insurance company so the best way to find out is to contact them directly.

Q. How long does a mastectomy operation take?

A. Normally, a mastectomy will take around 2 to 3 hours without complications.

Q. How long do I have to stay in hospital after my mastectomy?

A. Depending on whether or not there have been any complications during your procedure, the normal stay is around 4 to 7 days. If your surgeon has inserted drains into the breasts then as soon as the drains run clear and do not have blood in them, then they can be removed and the individual can be accessed to go home.

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