Understanding Mastectomy (Breast Removal Surgery)
There are numerous mastectomy procedures, each catering to distinct medical needs. Generally, the name of each mastectomy is decided based on how much tissue the surgeon removes during the process.
Breast cancer is one of the most common types of cancer to affect women across the globe. Since breast cancer can develop in different parts of the breast, including the ducts, lobules, and connective tissues, it is crucial to restrict its spread, especially in high-risk individuals.
One of the ways in which this is done is mastectomy, which is a medical intervention through which one or both of the breasts are removed. It can also be done as a preventive measure for individuals who are at a high risk of getting breast cancer.
The main aim of this procedure is to eliminate cancerous cells or reduce the risk of developing breast cancer in people who have a strong family history of the disease or specific genetic mutations.
For patients undergoing mastectomy, reconstructive surgery is often recommended to restore the breast's appearance, as it goes a long way in helping individuals regain confidence after a mastectomy surgery.
In most cases, the decision to undergo mastectomy depends on various factors, such as the extent of cancer, genetic predisposition, and the person's overall health.
To make the process of mastectomy simple and stress-free, women undergoing surgery must receive comprehensive support from healthcare professionals, including counseling and post-surgery care that is in line with their physical and emotional well-being.
What are the different types of mastectomy procedures?
There are numerous mastectomy procedures, each catering to distinct medical needs. Generally, the name of each mastectomy is decided based on how much tissue the surgeon removes during the process.
- Total mastectomy or simple mastectomy: A total or simple mastectomy removes the entire breast tissue but leaves the pectoral muscles beneath the breast intact. A total mastectomy can be performed on one breast (unilateral) or both breasts (bilateral).
- Double mastectomy or bilateral mastectomy: Also known as bilateral mastectomy, this surgery removes both breasts. It is performed when patients have cancerous cells in both their breasts or if they have a high risk of cancer recurrence in their breasts.
- Skin-sparing mastectomy or nipple-sparing mastectomy: A skin-sparing or nipple-sparing mastectomy removes the breast tissue without impacting the skin and nipple so that it can be reconstructed after the surgery.
- Mastectomy with breast reconstruction: Depending on a person’s specific condition, they can be eligible for breast reconstruction surgery at the same time as their mastectomy operation. It is also possible to schedule a breast reconstruction surgery at a later date.
- Modified radical mastectomy: A modified radical mastectomy removes all of the breast tissue along with the underarm lymph nodes on the same side. This surgery is done to restrict the spread of cancer, as this is often the first place from which breast cancer spreads to the rest of the body.
- Radical mastectomy: A radical mastectomy eliminates all of the breast tissue, underarm lymph nodes, and pectoral muscles underneath. This is a rare type of surgery but can be unavoidable, mainly if the cancer has spread to the person’s muscles.
Who can opt for mastectomy surgery?
Since mastectomy is a surgical option, it is considered for people who are suffering from a medical condition like breast cancer or those at high risk of developing this condition. The decision to undergo a mastectomy is highly personal and depends on various factors. Ahead are the main groups of individuals who may opt for mastectomy:
- Breast Cancer Patients: Women and, in sporadic cases, men diagnosed with breast cancer choose to undergo mastectomy as a part of their treatment plan. The type and extent of mastectomy depend on the stage of cancer and other medical considerations.
- High-risk Individuals: Individuals who have a strong family history of breast cancer or specific genetic mutations (such as BRCA1 or BRCA2) that can lead to a high risk of developing breast cancer are sometimes recommended to undergo mastectomy as a preventive measure. They might undergo this surgery even in the absence of diagnosed cancer.
- Previous Cancer Survivors: Individuals with a history of breast cancer who have undergone breast-conserving surgery and later experience a recurrence may also decide to go for a mastectomy surgery as part of their second-line treatment.
- Patients with Large Tumors or Multifocal Cancer: In cases where the tumor is large, or cancer is present in multiple areas of the breast, mastectomy is considered a way to prevent the disease from spreading.
Opting for mastectomy is a complex decision with far-reaching consequences, significantly impacting an individual's future lifestyle. Patients need to weigh the risks and benefits of mastectomy carefully and consider all available treatment options before making a decision.
Support from loved ones and mental health professionals can also be crucial in coping with the emotional impact of undergoing such a significant procedure.
This includes discussions with surgeons, oncologists, and genetic counselors to gain a comprehensive understanding of the physical and emotional implications of the procedure.
Is there life after a mastectomy?
Surgery is not the last stage for any patient undergoing breast cancer, although it can be a significant factor in the future treatment course and also bring a lot of relief from the condition. While we understand that losing breasts can bring many complicated emotions, there is no doubt that many people are satisfied with their breast reconstruction results.
Furthermore, today, with advanced technologies, there are multiple types of cosmetic options available to help survivors feel comfortable with their new, reconstructed, cancer-free breasts.
Finally, it is strongly advised that individuals who have undergone mastectomy adhere to their prescribed medications and supplements punctually to enhance their quality of life.
By maintaining a healthy lifestyle and seeking support when needed, individuals can navigate the physical and emotional challenges that come with mastectomy surgery.
These complementary measures contribute significantly to the overall health and recovery of individuals post-mastectomy. Individuals need to prioritize self-care and listen to their bodies during the recovery process.
[Dr. Bhavisha Ghugare, Surgical Oncology HCG Cancer Centre Borivali, Mumbai.]
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