Our Summary

The paper discusses a common surgical procedure for breast cancer, the modified radical mastectomy. The traditional method emphasizes on protecting certain nerves but often neglects the anterior thoracic nerve and intercostobrachial nerve. This neglect can result in patients experiencing numbness in the upper inside part of the arm, a burning sensation, pain, and shrinkage of the chest. The author of the paper presents a new method of conducting this surgery, which ensures the protection of these neglected nerves and includes a thorough cleaning of the third-level lymph nodes through the armpit. This may potentially reduce the post-operative issues patients often face.

FAQs

  1. What is a modified radical mastectomy?
  2. Why are the anterior thoracic nerve and intercostobrachial nerve often neglected in traditional methods of this surgery?
  3. What are the potential benefits of the new method of conducting a modified radical mastectomy presented in the paper?

Doctor’s Tip

A doctor might tell a patient undergoing a radical mastectomy to be aware of potential side effects such as numbness, pain, and shrinkage in the chest area. They may suggest seeking physical therapy or counseling to help manage any discomfort or emotional challenges post-surgery. Additionally, the doctor may recommend staying vigilant about monitoring for any signs of infection or lymphedema, and following a healthy diet and exercise routine to aid in the healing process.

Suitable For

Patients who are typically recommended for radical mastectomy include those with:

  • Large tumors that cannot be removed with lumpectomy or breast-conserving surgery
  • Tumors that have spread to the chest wall muscles or skin
  • Inflammatory breast cancer
  • Recurrent breast cancer after previous lumpectomy or radiation therapy
  • Presence of multiple tumors in different areas of the breast
  • Positive lymph nodes with extensive involvement
  • Genetic mutations such as BRCA1 or BRCA2 that increase the risk of breast cancer recurrence

It is important for patients to discuss with their healthcare provider about the best treatment options for their specific situation, as radical mastectomy is a major surgery with potential risks and side effects.

Timeline

Before radical mastectomy:

  1. Patient receives a breast cancer diagnosis and discusses treatment options with their healthcare provider.
  2. Patient undergoes pre-operative testing and evaluation to determine if they are a candidate for radical mastectomy.
  3. Patient may undergo chemotherapy or radiation therapy prior to surgery to shrink the tumor.
  4. Patient undergoes radical mastectomy surgery, which involves the removal of the entire breast, underlying chest muscles, and lymph nodes in the armpit.
  5. Patient may experience pain, swelling, and discomfort in the chest and arm following surgery.

After radical mastectomy:

  1. Patient begins the recovery process, which may include physical therapy to regain strength and range of motion in the arm and shoulder.
  2. Patient may experience emotional distress and body image issues related to the loss of their breast.
  3. Patient may undergo breast reconstruction surgery to restore the appearance of the breast.
  4. Patient may experience long-term side effects such as numbness, pain, and restricted movement in the arm and shoulder.
  5. Patient undergoes follow-up appointments and screenings to monitor for recurrence of breast cancer.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a radical mastectomy?
  2. How will the surgery impact my daily activities and quality of life?
  3. Will I need to undergo any additional treatments, such as radiation therapy or chemotherapy, after the surgery?
  4. How long is the recovery period following a radical mastectomy?
  5. What are the chances of the cancer recurring after this surgery?
  6. Will I need to undergo any additional surgeries or procedures in the future?
  7. How will the surgery affect the appearance of my breast(s) and chest area?
  8. What can I do to prepare for the surgery and optimize my recovery?
  9. Are there any alternative treatment options to consider before moving forward with a radical mastectomy?
  10. How frequently will I need to follow up with you after the surgery for monitoring and check-ups?

Reference

Authors: Huang S, Qiu P, Chen W, Zhang Y, Luo K, Li J. Journal: Gland Surg. 2020 Apr;9(2):463-466. doi: 10.21037/gs.2020.02.17. PMID: 32420275