Document Type : Original Article

Authors

1 Postgraduate Student, experimental sciences, Tabriz, Iran

2 Breast Surgery Fellowship, Tabriz University of Medical Sciences, Tabriz, Iran

10.22034/ijabbr.2023.703752

Abstract

Mastectomy is a method of treating breast cancer that is performed by surgically removing the breast and sometimes its adjacent tissues. In the past, radical mastectomy was the standard treatment for breast cancer, removing the entire breast, axillary lymph nodes, and some of the chest muscles below the breast, but surgical advances over the past 2 decades have given women more options than ever before. Less invasive breast-conserving treatments are available to many women. There are different types of mastectomies to deal with different medical conditions. Mastectomy can treat different types of breast cancer. Women who do not have cancer, but are at very high risk for breast cancer for any reason, may also have a mastectomy. This procedure may also be used as a cancer prevention method in people who are prone to breast cancer. Preventive mastectomy will reduce the risk of cancer by 90%.

Graphical Abstract

An Overview of Mastectomy and Its Types in the Treatment of Breast Cancer

Keywords

Introduction

One of the most common types of cancer is breast cancer, which many women suffer. Usually, this disease does not have any special signs or symptoms at first, but breast cancer can progress over time. Therefore, it will have irreparable consequences for health. One of the ways that will be very helpful to prevent the development of breast cancer is mastectomy surgery. For people who are in the initial stage of this disease, this method can have a very good effect.

 

Figure 1. Overview of breast conditions

Many people with breast cancer have successfully undergone mastectomy surgery. To check the progress of this disease and the necessary diagnosis to perform the essential surgeries, the best thing is to perform tests related to mammography, ultrasound, and radiology. Therefore, it is necessary to pay enough attention to the examinations and take this matter seriously.

What is a mastectomy?

Breast tissue surgery to treat or prevent breast cancer is performed in two ways: lumpectomy and mastectomy. In the lumpectomy method, usually the least required tissue is removed from the breast. On the other hand, it removes tumor and a margin of healthy tissue around it. Therefore, the surgeon can remove a small part of the breast tissue. On the other hand, mastectomy is a method used to prevent or treat cancer, whether the tumor is benign or malignant, the main goal of this surgery is to preserve the breast tissue. This method is a type of surgery in which both breasts are completely removed to prevent the progression of cancer. Of course, the amount of breast tissue removed in the mastectomy method depends on the extent of tumor and the degree of tissues involvement around the breast. Sometimes, the armpit lymph nodes and a number of breast muscles are checked and removed if necessary. There are different types of mastectomies, which we will discuss in full in the following sections.

Who should have a mastectomy?

  • If the tumor is large, the use of radiation therapy has not been effective, or radiation therapy is not possible at all.
  • If the tumor is in more than one area in the breast, the size of the breast can play a role in deciding this relationship.
  • In people whose cancerous mass is bigger than the breast tissue.

Of course, as it was mentioned, ultrasound, mammography, and radiology tests as well as examinations are very helpful for diagnosing the disease progress or even the size of tumors. In these three methods, the breast tissue and its surrounding areas are carefully examined and higher quality images are provided to people. According to the information recorded in the image, the specialist doctor will determine whether you need mastectomy surgery or not. Performing this surgery in the early stages of the disease will have a great impact on people's recovery.

Types of mastectomy methods

  1. Simple mastectomy: In this method, all the breast tissue is removed, but the lymph nodes and muscles under the breast are not removed. In simple mastectomy surgery, lymph nodes may be sampled during the operation.
  2. Radical mastectomy: In mastectomy, the biggest type of surgery is radical mastectomy. In this method, all breast tissue, nipple, areola around it, breast skin, and armpit lymph nodes are removed. In the radical type, the muscles under the breast are removed. Several years ago, the radical mastectomy method was known as a standard procedure, but today, with the advancement of science in medical fields and the use of new auxiliary methods, it is used less.

 

Figure 2. Radical mastectomy.

 

  1. Incomplete mastectomy: In this method, the surgeon removes the part of breast that is affected by cancer, plus the surrounding tissues. In incomplete mastectomy, more tissue is removed than lumpectomy. Incomplete mastectomy is also known as partial mastectomy.
  2. Skin-sparing mastectomy: In a skin-sparing mastectomy, the nipple, surrounding tissue, and lymph nodes are removed, but the skin of the breast is preserved. Many women who intend to reconstruct the breast choose this method.
  3. Mastectomy with protection of the skin, nipple, and surrounding tissue: This method is like a skin protection mastectomy with the difference that the nipple and brown tissue around it are further preserved. Usually, in this method, an incision is made under the breast in an area called the breast fold. Determining which method of mastectomy people should perform is only possible with the help of examinations and accurate diagnosis by the doctor.

Benefits of mastectomy

  1. Preventing the progression of cancer: Maybe many people get stressed when they hear the name of surgery and avoid doing it, but it is better to pay attention to the fact that if cancer masses are not treated and checked, these masses will grow bigger and affect the tissues. Adjacent or other parts of the body go. Therefore, by performing mastectomy surgery and removing cancerous tissue, breast cancer will not progress and the mass size will not increase. To ensure the health of breast tissue after mastectomy, the most suitable thing is to do imaging examinations. The use of specialized equipment as well as cooperation with expert and experienced medical staff at Taba Medical Imaging Center has made it possible to easily and accurately diagnose problems related to diseases of important tissues such as breast.
  2. Improving the process of the disease: Diagnosing the disease and performing mastectomy surgery in the early stages will have a great impact on the health of breast tissue. Some people may need radiation therapy and chemotherapy after this procedure. Using these methods, you will prevent the disease progress and you will be more confident about the breast health and its adjacent tissues.

Possible complications after mastectomy

After every operation, there is a possibility of problems and complications. Therefore, mastectomy surgery is not an exception to this rule, but most of the problems are minor and some of them can be serious. These complications include blood clotting. To prevent this, nurses make the patient walk and do leg exercises as soon as possible after the operation. Feeling of pain, swelling, and heat in the leg, shortness of breath and pain in the chest or upper back, bleeding, or wound infection, if there is redness, swelling or discharge at the wound site, you should consult a doctor. Pain in the movement organs in the operated area, especially in the shoulder, arm, or swollen hand, there may be a little swelling in the arm or hand after the operation, but it should be resolved very soon after the surgery. If the swelling does not go away or if you have pain or tenderness in the arm, you should tell your doctor as soon as possible because there is a risk of long-term swelling in the hand and arm after lymph node removal. This swelling is caused by lymphatic fluid that cannot be stored and can occur any time after surgery.

Conclusion

One of the ways to treat breast cancer is mastectomy surgery. In this method, all cancer cells are removed so that the breast tissue remains healthier and the disease does not spread to the other parts of the body. When the process of recovery and treatment will go very well, breast tissue can be examined accurately with the help of medical imaging.

How to cite this article: Parmiss Adyani Kalvanagh, Yousef Adyani Kalvanagh*‎. ‎ An Overview of Mastectomy and Its Types in ‎Treatment of Breast Cancer. International Journal of Advanced Biological and Biomedical Research, 2023, 11(1), ‎‎‎25-34‎‎‎. Link: http://www.ijabbr.com/article_703752.html

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