Mastectomy involves removing a patient’s mammary gland on one or both sides. Most commonly, this procedure takes place as part of cancer treatment. Depending on the amount of tissue removed and the incision made, women may not be able to breastfeed after a mastectomy.
What is mastectomy?
A mastectomy involves removing a patient’s mammary gland on one or both sides. Most commonly, this procedure takes place as part of cancer treatment. Removal of the mammary gland is called a mastectomy in medical terminology. A mastectomy can be the removal of both the female and male mammary glands. Mastectomy is often equated with mastectomy. This is not entirely true, as mastectomies involve the removal of all breast tissue, including the nipples. This is not necessarily the case with mastectomy. The procedure is often followed by reconstructive measures, such as the fitting of breast implants. Most often, mastectomies take place as part of cancer prevention or cancer therapy. Religious mastectomies have also occurred historically, however. In the Russian sect of the Skops, for example, mastectomy was among a widespread rite intended to reduce sexual desire among sect members.
Function, effect, and goals
The indication for mastectomy is primarily for malignant processes in the breast. This is especially true for carcinomas whose size is relatively extensive in relation to the overall size of the breast. In particular, patients who are pregnant and those with conditions such as scleroderma have little choice but to have the mammary gland, including the surrounding tissue, removed in the case of breast cancer. In cases of genetic risk for breast cancer, mastectomies sometimes take place as a preventive measure. More rarely, the procedures are indicated in the context of sex reassignment surgery. Sometimes the operations are even performed as purely aesthetic procedures aimed at reducing the size of the breasts. In this case, the surgery is not performed unilaterally, i.e. on one side, but bilaterally. Depending on the goal of a mastectomy or how much tissue is affected by a malignant process, the surgery can take on different proportions. Partial mastectomies such as lumpectomy or quadrantectomy, for example, remove only a tiny portion of the breast. In a lumpectomy, only the tumor itself is removed along with its adjacent tissue, and the breast remains largely intact. Partial mastectomies of this type are distinguished from total mastectomies, in which the entire mammary gland is removed. In subcutaneous total mastectomy, the areola and skin are preserved. In simple total mastectomy, the affected area of skin is also removed. The same applies to nearby fatty tissue and the fascia of the pectoral muscle. In modified radical mastectomy, the lymphatic tissue of the axillary area is also removed. Radical mastectomy with additional removal of an entire muscle is rarely used today. The length of stay in hospital is usually between three and ten days. In the case of mastectomies for cosmetic reasons, depending on the size of the breast and thus the amount of tissue to be removed, the procedure is usually divided into two operations, with a period of six or even twelve months between them. In all types of mastectomy, the patient is given antibiotic prophylaxis in advance. To educate the patient, a detailed educational consultation is usually held the day before surgery. If non-palpable changes in the breast are to be removed, the areas to be removed are marked with a dye or fine wire. Patients usually wear a compression bandage for the first 24 hours after surgery. Breast cancer patients usually have a quarterly review of their findings after mastectomy.
Risks, side effects, and hazards
In addition to general surgical and anesthesia risks, mastectomy is particularly associated with an increased risk of adhesions. Infections and disturbances in wound healing may occur. The same applies to hematomas and paresthesias, such as persistent numbness or other sensory disturbances of the surrounding skin area. Sometimes an abnormal amount of wound fluid also accumulates on the operated area.Bleeding, water retention and suture insufficiencies are also possible. However, serious complications are rather rare according to the current state of the art. Thus, mastectomy is a relatively safe standard procedure in current medicine. As a rule, mastectomies are associated with pain, but the doctor may be able to counteract this with the administration of painkillers. A female breast mastectomy may or may not affect the ability to breastfeed. Decisive factors in this regard are the incision, the amount of tissue removed, and the involvement of nerves, milk ducts, and blood vessels. Often, women feel that they have been deprived of their femininity after a mastectomy. This feeling can make breastfeeding difficult even when it would actually be possible anatomically after the mastectomy. For example, many women suffer severe psychological problems after the operation. However, psychotherapy and breast reconstruction can sometimes make these after-effects of the operation subside completely. Mastectomy sometimes allows breast cancer patients to forego radiation therapy altogether, as may be recommended for health reasons. Nevertheless, the procedure is not an undoubted guarantee of recovery from a malignant process. Recurrences are always conceivable.
