Mastectomy

What does mastectomy mean? For whom is mastectomy performed and how is the procedure performed? What are the surgical techniques and types of mastectomy applied in breast cancer? Learn about the Breast Reconstruction process in this article of Professor Dr Şükrü Yazar.

What is a Mastectomy?

Mastectomy is the name given to the surgeries performed in order to remove the cancer tissue in the breast. Mastectomy is preferred for patients with tumours that are widespread in the past, but now it is only preferred where conservative breast surgery is not suitable and which are widely distributed.

The general surgery team operates the patient with breast cancer. Cancer tissue is excised according to the size and type of tumour in the breast. Since the types of cancer are different, the way and procedure of breast cancer surgery can vary. If the cancer is of a small and harmful type, it may be sufficient to take only the affected tissue in the surgery. The shape of the breast is provided in the remaining breast tissue.

Which Patients Undergo Mastectomy?

A mastectomy operation is a surgical procedure that is performed in individuals who needs their breasts to be excised partially or totally due to cancer. Mastectomy can be performed to patients of any age after diagnosis. This procedure should be performed in people whose diagnosis is accurate. It can also be done to protect the patients at high risk. This prevention is called prophylactic mastectomy; it is performed by plastic surgeons to prevent the risk of cancer that may occur later in the breast, to reshape the breast and reconstruct the breast (breast reconstruction).

How is Mastectomy Performed?

Depending on the size and type of cancer, the content, process and completion time of the mastectomy surgery may vary. In cases where breast cancer is aggressive, breast emptying procedures are required. In suitable patients the skin protection procedure called Skin Conservative Mastectomy can be performed while in some cases, skin and nipple protection can be performed with the process called Simple Mastectomy.

Issues and criteria to be considered in every surgical approach should be applied to mastectomy surgeries as well. You should have your surgery with a sense of trust by entrusting yourself to a breast cancer surgeon with skills and experience.

What are Surgical Techniques in Breast Cancer?
(Mastectomy Types)

• Breast-Conserving Surgery:
  In some cases, mastectomy can also be done to minimise the risk. Mastectomy can also be applied to the disease-free breast for minimising the risk and protection, if the breast cancer is inherited, especially in the family, in first-degree relatives. This practice is called breast-conserving surgery.
• Skin-Protective Mastectomy (Skin Conservative):
  Sometimes breasts can be restructured in female patients during the surgery. This procedure is called Skin-Protective Mastectomy. Most of the skin (including the nipple circumference – areola – and the nipple) on the breast is left untouched. Patients can benefit from Skin-Protective Mastectomy as much as a Simple Mastectomy. The amount of breast tissue excised can be the same as the amount extracted in Simple Mastectomy.
• Nipple-Protective Mastectomy (Nipple conservative):
  Such breast surgeries can be performed as skin-protective in early-stage tumours and as nipple-protective in tumours that are located away from the nipple.
• Total (Simple) Mastectomy:
  It is also called Simple Mastectomy (Segmental Mastectomy). In this mastectomy type, all of the breast tissue is removed, including nipples. However, axillary lymph nodes or muscle tissues are not removed. In some special cases, both breasts are excised for protection in female patients who have a high risk, which is called a ‘Double Mastectomy.’ Many of the patients who have been hospitalised for this surgery can be discharged the next day. Total Mastectomy is a method that is used frequently in the treatment of breast cancer.
• Other Mastectomy Types
  • Extended Mastectomy
  • Modified Radical Mastectomy
  • Radical Mastectomy
  • Lymph Node Surgeries
    • Sentinel Lymph Node Biopsy
    • Axillary Lymph Node Dissection

At the same time, in these surgeries for the management, simultaneous reconstructive procedures (full name: Plastic Reconstructive and Aesthetic Surgery) can be performed in case of collaboration with the plastic surgeon.

During surgery where the nipple is protected, under the effect of anaesthesia, a single dose of radiotherapy (the process using ionising beam) can be given.

Breast Reconstruction

In the treatment of breast cancer, breast reconstruction (new breast construction) after mastectomy can perform in the same session or later. Breast reconstruction can be performed in the same session in surgeries performed for prophylaxis or early breast cancer. In advanced-stage breast cancers, breast reconstruction is performed 5-7 months after the completion of chemotherapy and radiotherapy.