Our Summary

This research paper discusses a study that compared two different surgical techniques used for mastectomies (breast removal surgeries): tumescent dissection (TUM) and standard electrocautery dissection. TUM is a method that uses a special fluid to help lift the skin without causing bleeding, while electrocautery uses heat to cut and seal tissues.

The study looked at the medical records of patients who had mastectomies performed by the same surgeon between 2016 and 2020. They were interested in comparing the rate of complications and the time it took to perform the surgeries.

The results showed that a lower percentage of patients who had the TUM procedure experienced complications compared to those who had the electrocautery procedure. Also, the TUM procedure took less time to perform on average. However, there was a higher infection rate in the TUM group who had reconstruction surgery compared to the electrocautery group who had reconstruction surgery.

The researchers concluded that the TUM method is a good alternative to electrocautery, as it has fewer overall complications and takes less time. They suggested that the heat used in electrocautery might be responsible for skin-related complications. The shorter surgery time with TUM could also reduce the risk of complications from being under general anesthesia for a long time.

FAQs

  1. What are the two surgical techniques compared in this study for mastectomies?
  2. How did the complication and surgery time rates differ between the TUM and electrocautery procedures?
  3. Why did the researchers conclude that the TUM method is a good alternative to electrocautery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about mastectomy is to inquire about the use of tumescent dissection (TUM) as a surgical technique. This method has been shown to have lower complication rates and shorter surgical times compared to standard electrocautery dissection. It may be worth discussing with your surgeon as a potential option for your mastectomy procedure.

Suitable For

Typically, patients who are recommended for mastectomy include those with:

  1. Breast cancer: Mastectomy is often recommended for patients with early-stage breast cancer, especially if the tumor is large relative to the size of the breast, if there are multiple tumors in the breast, or if the cancer has spread to multiple areas of the breast.

  2. BRCA gene mutation: Patients with a BRCA gene mutation, which significantly increases the risk of developing breast cancer, may choose to undergo a prophylactic mastectomy to reduce their risk.

  3. Ductal carcinoma in situ (DCIS): Patients with DCIS, a non-invasive breast cancer, may undergo mastectomy if the area affected is large or if the patient is at high risk of recurrence.

  4. High risk of breast cancer recurrence: Patients with a history of breast cancer recurrence or with a high risk of recurrence may choose mastectomy as a preventive measure.

  5. Large breast size: Patients with large breasts may choose mastectomy for cosmetic reasons or to reduce the risk of breast cancer.

  6. Failed lumpectomy: Patients who have undergone a lumpectomy (breast-conserving surgery) and have a recurrence of cancer in the same breast may be recommended for mastectomy.

  7. Inflammatory breast cancer: Mastectomy is often recommended for patients with inflammatory breast cancer, a rare and aggressive form of breast cancer.

It is important for patients to discuss their individual circumstances with their healthcare provider to determine if mastectomy is the best treatment option for them.

Timeline

Before the mastectomy:

  1. Patient receives a diagnosis of breast cancer or other medical condition requiring a mastectomy.
  2. Patient discusses treatment options with their healthcare provider and decides to proceed with a mastectomy.
  3. Patient undergoes pre-operative testing and preparation for surgery.
  4. Patient may undergo genetic testing and counseling if indicated.
  5. Patient discusses reconstructive options with their healthcare provider.
  6. Patient mentally prepares for the physical and emotional impact of the surgery.

After the mastectomy:

  1. Patient undergoes the mastectomy surgery, either with TUM or electrocautery dissection.
  2. Patient is monitored in the recovery room and then transferred to a hospital room for further observation.
  3. Patient experiences pain, swelling, and discomfort in the chest area.
  4. Patient receives post-operative care, including wound care, pain management, and physical therapy.
  5. Patient may begin the process of breast reconstruction if desired.
  6. Patient attends follow-up appointments with their healthcare provider to monitor healing and address any complications.
  7. Patient may experience emotional and psychological challenges related to body image and self-esteem.
  8. Patient begins the process of adjusting to life after mastectomy, potentially with the support of a healthcare team, support groups, and counseling.

What to Ask Your Doctor

Some questions a patient should ask their doctor about mastectomy include:

  1. What are the different surgical techniques available for mastectomy, and what are the benefits and risks of each?
  2. How does the tumescent dissection (TUM) method compare to standard electrocautery dissection in terms of complications and recovery time?
  3. What is the infection rate associated with each surgical technique, especially if reconstruction surgery is planned?
  4. How long will the surgery take with each method, and what are the implications of a longer surgery time in terms of anesthesia and recovery?
  5. Are there any specific factors about my health or breast cancer diagnosis that make one surgical technique more suitable for me than the other?
  6. What are the potential long-term effects of each surgical technique on breast appearance, sensation, and function?
  7. How experienced are you in performing mastectomies using the TUM method, and what is your success rate with this technique?
  8. How will pain management differ between the two surgical techniques, and what can I expect in terms of post-operative discomfort?
  9. What will my follow-up care look like after the surgery, and how will you monitor for any potential complications?
  10. Are there any specific questions or concerns I should address with the plastic surgeon if reconstruction surgery is part of my treatment plan?

Reference

Authors: Bakillah E, Brooks AD, Adekeye S. Journal: Breast J. 2025 Jan 27;2025:7634729. doi: 10.1155/tbj/7634729. eCollection 2025. PMID: 39950031