What diagnostics should always be performed before a mastectomy? | Mastectomy

What diagnostics should always be performed before a mastectomy?

The diagnostic procedure to be performed before a mastectomy depends on the clinical picture. In the case of tumor diseases of the breast, it is essential to distinguish between benign (e.g. fibroadenoma) and malignant (breast cancer) changes. For this purpose, a mammography examination is first of all used, which often reveals indications of the malignancy or benignity of a suspicious area.

An ultrasound examination of the breast is often used as a supporting measure. In unclear cases or to determine the extent of a finding, MRI (magnetic resonance imaging) is used less frequently. Ultimately, however, benign and malignant tumors can often only be reliably distinguished by means of a tissue sample (biopsy).

This differentiation determines to a large extent the surgical technique and the use of further diagnostics. In the case of a malignant tumor, the so-called sentinel lymph node is often determined before surgery. This is the first point of contact for spreading tumor cells and must be examined during surgery.If it is affected by cancer cells, other lymph nodes (especially in the armpit) must also be removed, and lymph node metastasis is present.

Procedure of a mastectomy

A mastectomy (removal of the mammary gland) is usually performed in a larger hospital that has a gynecological (gynecological) department. If the mastectomy is performed because of the indication of breast cancer, in many cases the operation in a breast center is recommended, since here the interdisciplinary further care (radiation, chemotherapy, pain therapy, etc.) is also ensured.

A mastectomy is always performed under general anesthesia and is part of an inpatient stay of several days. There are various forms of surgical techniques, which differ in their radicality (see above). Depending on the infestation and disease, only one or both mammary glands are removed.

The glandular body and other structures (e.g. lymph nodes, depending on the surgical procedure) are removed through a single skin incision. In the case of a malignant tumor, lymph nodes are examined for tumor cells under the microscope during the operation (so-called frozen section). If cancer cells are already present in the examined lymph nodes, further lymph nodes in the drainage area of the mammary gland must be removed.

Towards the end of the operation, which can take several hours depending on the extent of the operation, the edges of the incision are placed together without tension and closed with a suture. A drainage tube is also inserted to ensure the drainage of blood and wound secretion. The surgical wound is now sterilely dressed and the patient is transferred to the recovery room to wake up.