Our Summary

The research paper discusses changes in the treatment of breast cancer over the course of the 20th century. In the past, a radical mastectomy, which involves the removal of the entire breast, was the primary treatment. As our understanding of breast cancer has improved, there’s been a shift towards less invasive surgeries. Nowadays, most women who need a mastectomy can have either a skin-sparing or nipple-sparing surgery. These types of surgeries leave some parts of the breast intact, which can result in a better cosmetic appearance without affecting the success of the cancer treatment. Currently, around 40% of women with breast cancer are treated with a mastectomy.

FAQs

  1. What is the role of mastectomy in breast cancer treatment?
  2. What are skin-sparing and nipple-sparing mastectomies and do they affect cancer treatment outcomes?
  3. What percentage of women undergo mastectomy for breast cancer treatment?

Doctor’s Tip

A doctor might tell a patient undergoing a mastectomy to make sure to follow post-operative care instructions carefully, including proper wound care, pain management, and any recommended physical therapy. It’s also important to attend all follow-up appointments to monitor healing and address any concerns or complications promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support overall recovery and well-being after surgery.

Suitable For

Patients who are typically recommended mastectomy include:

  1. Women with early-stage breast cancer who are not candidates for breast-conserving surgery (lumpectomy) due to the size or location of the tumor.
  2. Women with a genetic predisposition to breast cancer, such as those with BRCA1 or BRCA2 mutations, who have a high risk of developing breast cancer.
  3. Women with a history of previous radiation therapy to the breast, which may increase the risk of complications with repeat radiation therapy.
  4. Women with multiple areas of cancer in the breast, known as multifocal or multicentric breast cancer, which may not be effectively treated with lumpectomy.
  5. Women with inflammatory breast cancer, a rare and aggressive form of breast cancer that often requires more extensive surgical intervention.
  6. Women with large or locally advanced breast tumors that may require removal of a significant amount of breast tissue to achieve adequate oncologic margins.
  7. Women with recurrent breast cancer in the same breast after previous lumpectomy and radiation therapy.
  8. Women who have a strong preference for mastectomy over lumpectomy for personal or psychological reasons.

Timeline

Before mastectomy:

  • Diagnosis of breast cancer through imaging tests (mammogram, ultrasound, MRI) and biopsy
  • Consultation with a breast surgeon to discuss treatment options
  • Decision to undergo mastectomy based on tumor size, location, and stage of cancer
  • Pre-operative appointments for medical clearance, bloodwork, and imaging
  • Education on what to expect during and after surgery
  • Possible reconstruction options discussed with plastic surgeon

After mastectomy:

  • Surgery day: patient is under general anesthesia for 2-3 hours
  • Hospital stay of 1-2 days for recovery
  • Pain management and wound care post-surgery
  • Drain tubes may be placed to remove excess fluid from surgical site
  • Follow-up appointments with surgeon and oncologist for pathology results and treatment plan
  • Physical therapy and/or exercises to regain range of motion and strength in arm and chest
  • Emotional support and counseling for coping with body image changes
  • Reconstruction surgery may be scheduled at a later date if desired
  • Ongoing surveillance for recurrence and follow-up care with oncologist and surgeon.

What to Ask Your Doctor

  1. What type of mastectomy is recommended for my specific case?
  2. What are the risks and benefits of a skin-sparing or nipple-sparing mastectomy compared to a traditional mastectomy?
  3. How will a mastectomy affect my physical appearance and self-esteem?
  4. What is the recovery process like after a mastectomy?
  5. Will I need additional treatments such as radiation or chemotherapy after the mastectomy?
  6. What are the chances of the cancer returning after a mastectomy?
  7. Are there alternative treatment options to consider instead of a mastectomy?
  8. How often will I need follow-up appointments and screenings after the mastectomy?
  9. Will I need reconstructive surgery after the mastectomy, and if so, what are the options available?
  10. Are there any long-term side effects or complications associated with a mastectomy that I should be aware of?

Reference

Authors: Jones C, Lancaster R. Journal: Surg Clin North Am. 2018 Aug;98(4):835-844. doi: 10.1016/j.suc.2018.04.003. Epub 2018 May 21. PMID: 30005777