MODIFIED RADICAL MASTECTOMY.pptx hhfgcdtyuhdetgvvhhtrvb b bffff

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1. MODIFIED RADICAL MASTECTOMY

2. INDICATIONS IN CA.BREAST- LARGE TUMOR IN SMALL BREAST CENTRAL TUMORS MULTIFOCAL DISEASE LOCAL RECURRENCE PATIENT PREFERENCE

3. POSITION SUPINE POSITION ARM ABDUCTED PILLOW UNDER THE SHOULDER

4. ANAESTHESIA GENERAL THORACIC EPIDURAL

5. INCISION ELLIPTICAL INCISION ENCIRCLING THE TUMOR AND NIPPLE AREOLA COMPLEX AXIS OF ELLIPSE DEPENDS ON SITE OF TUMOR TRANSVERSE ELLIPSE IS USUALLY SUFFICIENT

6. PROCEDURE SKIN FLAPS ARE RAISED UPTO CLAVICLE AND COSTAL MARGIN EN BLOC DISSECTION OF: BREAST WITH TUMOR AND NIPPLE PECTORALIS MAJOR PECTORALIS MINOR AXILLARY FAT,LYMPHATICS,NODES WOUND DRAINED SKIN CLOSED

7. STRUCTURES PRESERVED AXILLARY VIEN CEPHALIC VEIN NERVE TO SERRATUS NERVE TO LATISSIMUS

8. COMPLICATIONS SEROMA INFECTION AXILLARY VEIN DAMAGE SHOULDER STIFFNESS

9. RELEVENT QUESTIONS What is Halsted’s mastectomy Patey’s mastectomy QUART Non surgical treatment Chemo regimes Harmonal Rx Simple mastectomy Prophylactic mastectomy Triple assessment Conservative surgery

10. R Q CONTD Features of lymphatic obstruction Axillary node groups Levels of axillary nodes Tamoxifen Prognostic indicators LCIS,DCIS Familial ca.breast