Mastectomy

Mastectomy is the removal of the whole breast. There are five different types of mastectomy: "simple" or "total" mastectomy, modified radical mastectomy, radical mastectomy, partial mastectomy, and subcutaneous (nipple-sparing) mastectomy.

1. Mastectomy Prepared by: Adan Sawalmeh Supervisor: Dr. Ali Abu Arra

2. Overview: Definition Types of mastectomy Operative procedure Mastectomy risks Mastectomy Plus Reconstruction

3. A mastectomy is surgery to remove a breast. In the past, a radical mastectomy with complete removal of the breast was the standard treatment for breast cancer. But surgical breakthroughs over the past 2 decades have given women more options than ever before. Less invasive breast-conserving treatments are available to many women Definition

4. Unable to have radiation therapy, or would prefer a more extensive surgery to having radiation therapy Have already had the breast treated with radiation therapy Have a larger tumor (greater than 5 cm [2 inches] across), or a tumor that is large relative to your breast size Are pregnant and would need radiation therapy while still pregnant (risking harm to the fetus ) Have a genetic factor such as a  BRCA  mutation, which might increase your chance of a second cancer Have a serious connective tissue disease such as scleroderma or lupus, which may make you . especially sensitive to the side effects of radiation therapy Have inflammatory breast cancer  mastectomy might be recommended if:  

5. The type of mastectomy that’s right for you depends on several things, including: Age General health Menopause status Tumor size Tumor stage (how far it's spread) Tumor grade (its aggressiveness) Tumor's hormone receptor status Whether or not lymph nodes are involved

6. Types of mastectomy:   Total Mastectomy Also called simple mastectomy, with this procedure, your doctor removes your entire breast, including the nipple. But your lymph nodes, the small glands that are part of your immune system, aren’t removed . total mastectomy performed if   cancer isn’t in lymph nodes. Preventive Mastectomy Women who have a high risk of breast cancer may choose to have a preventive mastectomy, also called prophylactic mastectomy. Studies show that women with a high risk of breast cancer may be as much as 90% less likely to get the disease after preventive mastectomy.

7. Some women who've had breast cancer in one breast will decide to have a preventive mastectomy to remove the other breast. This can reduce the chance of cancer reoccurrence. Partial mastectomy Partial mastectomy is the removal of the cancerous part of the breast tissue and some normal tissue around it . Radical Mastectomy A radical mastectomy is the complete removal of the breast, including the nipple. The surgeon also removes the overlying skin, the muscles beneath the breast, and the lymph nodes. Because radical mastectomy isn't more effective than other less extreme forms of mastectomy, it's rarely performed today. It’s only recommended when the cancer has spread to the chest muscle.

8. Nipple-sparing mastectomy During nipple-sparing mastectomy, all of the breast tissue is removed, but the nipple is left alone . CT scan for -A 52-year-old woman with mastectomy and radiotherapy for primary intraductal -

9. Operative procedure • Anesthesia – General anesthesia • Position – The patient is placed in supine position with the arm abducted < 90 degree. – Sandbag or folded sheet is placed under the thorax and shoulder of affected side. Incision: – Oblique elliptical incision angled towards axilla.

10. Some women decide to have the breast rebuilt, or reconstructed, during the same operation that removes the breast. This is called “immediate reconstruction.” Other women may wait months or years to have a breast reconstructed. There are many ways to reconstruct a breast. Different techniques include inserting an implant, inserting tissue from another part of your body, or using a combination . Regardless of whether you are thinking about having immediate or later breast reconstruction, it’s important to plan reconstruction at a time that works well for you. For instance, healing from reconstruction surgery can sometimes cause delays for women who need prompt chemotherapy. Many surgeons also believe that radiation to a reconstructed breast can compromise the appearance and feeling of the reconstruction. Therefore, in most cases, breast reconstruction should wait until both chemotherapy and radiation are completed. Mastectomy Plus Reconstruction

11. Numbness of the skin along the incision site and mild to moderate tenderness of the adjacent area Extra sensitivity to touch within the area of surgery Fluid collecting under the scar Delayed wound healing Increased risk of infection in the surgical area Scar tissue formation Mastectomy risks

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