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Mastectomy

Definition

A mastectomy is a surgical procedure in which part, or all, of the breast is removed. Healthy tissue around the breast as well as lymph nodes in the armpit, may also be removed.

Who is a candidate for the procedure?

A mastectomy is generally done in women with a diagnosis of breast cancer. It may occasionally be recommended for a woman with a strong family history of breast cancer but who has not developed it herself, to prevent a cancer from occurring in her breasts Women who are positive for a breast cancer gene, such as BRCA 1 and BRCA 2, may choose mastectomy for the same reason.

How is the procedure performed?

The woman is put to sleep under general anesthesia. The skin over the affected breast, the chest, and the upper arm is cleansed with an antiseptic. An incision is made that may or may not include the nipple and the pigmented skin around the nipple, called the areola.
The incision may be horizontal from the breastbone to the underarm. Occasionally, if the tumor is higher up, the incision is diagonal from the upper part of the armpit down to the breastbone. The surgeon may be able to include any previous biopsy incision, for cosmetic reasons.
The breast tissue is then removed and sent to the laboratory for analysis Some women choose to have a reconstruction with placement of a fluid-filled implant done at this same time. Other women may have that done at a later time, or not at all.
The chest wall incision is closed with sutures or staples. Small tubes are placed through the skin to drain any fluid that might build up in the area. A large bandage is placed over the incision and taped firmly in place. This pressure dressing keeps the skin against the chest wall muscles. This reduces the fluid buildup and promotes drainage.

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