What is mastectomy and how do people live after it?
Miscellaneous / / November 11, 2021
This surgery is performed to treat and prevent cancer.
What is Mastectomy
MastectomyMastectomy / Mayo Clinic - This is a surgical operation during which all or part of the breast tissue is removed. This intervention is used to treat or prevent cancer.Preventive (prophylactic) mastectomy: Surgery to reduce breast cancer risk / Mayo Clinic .
Mastectomy is done for both women and men.
When is a mastectomy needed?
The main indication for surgery is various types of breast cancer. It canMastectomy / Mayo Clinic to be:
- intraductal carcinoma - a tumor growing inside the milk duct;
- I or II (early) stage of breast cancer;
- Stage III breast cancer. In this case, the mastectomy is performed after chemotherapy;
- inflammatory carcinoma - a fast-growing, aggressive tumor;
- Paget's cancer - a malignant tumor of the nipples;
- locally recurrent breast cancer - when the tumor has returned some time after the previous treatment.
Also some women are hesitantPreventive (prophylactic) mastectomy: Surgery to reduce breast cancer risk / Mayo Clinic
for a mastectomy to prevent breast cancer. The fact is that often the predisposition to this disease is inherited. Therefore, genetic testing can be done. If doctors find a mutation in the BRCA1 and BRCA2 genes, this indicates a high risk of cancer.What is a mastectomy
Depending on the size and type of tumor, its location, stage of the disease, the doctor will choose one of the following typesMastectomy / NHS mastectomy:
- Standard (simple). All breast tissue, nipple and much of the skin are removed.
- Skin-sparing. The doctor cuts off the mammary gland and nipple, but retains most of the skin.
- With preservation of the nipples. In this case, all other tissues of the gland are removed.
- Radical. In addition to the breast, the skin above it and the nipple, muscles under the mammary gland and axillary lymph nodes are removed. Such an operation is performed very rarely, as it is extremely traumatic.
- Modified radical. They do everything the same as in the previous version, but do not touch the muscles.
Why is mastectomy dangerous?
As with any surgery, there is a risk of complications both during and after the procedure. It can beMastectomy / Mayo Clinic:
- Bleeding. It can occur during a mastectomy. And in some, after the operation, then the blood accumulates under the skin and a hematoma is formed.
- Wound infection. If germs get into it, inflammation will occur, which will impair healing.
- Strong pain. Sometimes she worries even after the wound has healed.
- Chronic seroma. This is the accumulation of lymphatic fluid in the tissues.
- Formation of the rough scar. Some women develop a very dense scar after the wound heals, which is uncomfortable.
- Shoulder pain and stiffness.
- Feeling numb. Usually appears if the axillary lymph node had to be removed.
- Lymphedema of the hand. This is a violation of the outflow of lymph from the limb on the side of the operation. It occurs due to the fact that the lymph nodes had to be removed, and the rest are not able to pass all the lymph through themselves.
The risk of developing complications is higherModified Radical Mastectomy / Medscape in patients with diabetes mellitus, those who smoke, have had radiation therapy to the chest, or have vascular disease.
How to prepare for a mastectomy
Before the operation, the person will be prescribedMastectomy / U.S. National Library of Medicine examination. These are blood tests, as well as CT scans, chest or bone x-rays, to understand how cancer spreads outside the breast and into the lymphatic system.
In some cases, prior to surgery,Mastectomy / NHS chemotherapy or hormone therapy. This helps to shrink the tumor.
For those who undergo mastectomy for prophylaxis, at this stage, a standard preoperative examination is sufficient, which includes blood tests and urine and EKG.
Also, the issue is discussed in advance, you needMastectomy / Mayo Clinic whether breast reconstruction. For a woman, right after the removal of the breast, the doctor can place a silicone or saline implant or use her own tissues to maintain an aesthetic shape.
A week before the operation, you need to stop using drugs that reduce blood clotting. These are OTC pain relievers, anticoagulants, and vitamin E.
8-12 hours before the procedure, you cannotMastectomy / Mayo Clinic eat and drink.
How is a mastectomy done?
The operation is performed under general anesthesia, so the person will sleep soundly and feel nothing. The procedure usually takesMastectomy / NHS about 90 minutes, although it can be longer.
The doctor will make a neat incision under the breast and remove the tissue. Then their samples will be sent to the laboratory for histological examination to study the tumor cells and prescribe further treatment.
Then spendMastectomy / Mayo Clinic reconstruction. And sometimes temporary dilators are sewn under the skin to help maintain the shape of the breast for subsequent plastic surgery. It is performed after the end of the course of radiation therapy.
At the end of the mastectomy, the skin will be leftMastectomy / NHS drainage tubes. They are needed so that lymphatic fluid flows out from under the skin and a seroma does not form.
The attachments will not be removed for several days.
What to expect immediately after a mastectomy
The patient will be monitored by medical staff for several days. Doctors will prescribeMastectomy / Mayo Clinic strong pain relievers, drips to restore water balance, antibiotics to prevent infection.
Dressings should be done daily and the condition of the chest should be monitored. Usually removed after 10 daysMastectomy - discharge / U.S. National Library of Medicine stitches, but the wound heals completelyMastectomy / NHS only after 2-3 weeks. By this time, the result of histology is already ready, and the doctor may suggest further treatment - radiation or chemotherapy.
Full recovery from surgery may takeMastectomy / NHS up to 6 weeks.
How do people live after a mastectomy?
In the first few weeks, the wound willMastectomy - discharge / U.S. National Library of Medicine get sick. Therefore, you can ask your doctor for an effective pain reliever. An ice pack can also help reduce swelling and discomfort. But you need to apply it for no more than 15 minutes at a time.
Until the wound heals, you can not take a hot bath, go to the pool. It is permissible to wash in the shower, but do not rub the skin of the chest.
After the operation, you can do any work at home that does not cause pain. Using your hand on the injured side is also permitted. But usually after the procedure they giveMastectomy / NHS sick leave for a period of 4 to 8 weeks.
It is allowed to drive a car only if the patient is not taking drugs. painkillers and it doesn't hurt him to turn the steering wheel.
Some women after mastectomy useMastectomy - discharge / U.S. National Library of Medicine special bras with an insert to create a shape in the place of the removed breast.
You also need to remember that after removal of the mammary gland, the outflow of lymph from the hand worsens. To prevent lymphedema from developing, doctors recommendLymphedema - self-care / U.S. National Library of Medicine follow these rules:
- Be sure to use your hand on the side of the operation. You can brush your hair, dress or eat.
- Hold your hand above heart level 2-3 times a day, for example when lying down. To do this, place a pillow under it. Maintain this position for at least 45 minutes. And to improve the outflow of lymph, you need to clench a fist 15-25 times at this time.
- Protect your skin from injury. To do this, use an electric shaver to shave your armpits, wear gloves when working at home or in the garden, do not sunbathe or use cream with SPF 30. Use insect repellents to protect yourself from insect bites.
- If you need to donate blood from a vein or give an injection, give the technician a healthy hand.
- Do not handle very cold or hot objects. Also, you can not go to the sauna or bath.
- Do not wear tight clothing or jewelry that can pinch the skin and impair the flow of lymph from the arm on the side of the operation.
- Only carry your purse in your healthy hand.
In some cases, to improve the flow of lymph from the hand, doctors prescribe special exercises, massage, or a compression sleeve that is worn at night. Most likely, you will have to follow these recommendations for the rest of your life.
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