In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the The breast is the upper Ventral region of an animal’s Torso, particularly that of Mammals including Human beings. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. Breast cancer is a Cancer that starts in the cells of the Breast in women and men Prophylaxis ( Greek "προφυλάσσω" to guard or prevent beforehand) is any medical or Public health procedure whose purpose It is also the medical procedure carried out to remove breast cancer (tissue) in males. Alternatively, certain patients can choose to have a wide local excision (also called a lumpectomy), an operation in which a small volume of breast tissue containing the tumor and some surrounding healthy tissue is removed to conserve the breast. A wide local excision (WLE is a surgical procedure to remove a small area of diseased or problematic tissue with a margin of normal tissue Lumpectomy is a common Surgical procedure designed to remove a discrete lump usually a Tumor, benign or otherwise from an affected man or woman's Breast See also Cancer A tumor or tumour is the name for a swelling or lesion formed by an abnormal growth of cells (termed neoplastic Both mastectomy and lumpectomy are what are referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

Traditionally, in the case of breast cancer, the whole breast was removed. Currently the decision to do the mastectomy is based on various factors including breast size, number of lesions, biologic aggressiveness of a breast cancer, the availability of adjuvant radiation, and the willingness of the patient to accept higher rates of tumor recurrences after lumpectomy and radiation. Outcome studies comparing mastectomy to lumpectomy with radiation have suggested that routine radical mastectomy surgeries will not always prevent later distant secondary tumors arising from micro-metastases prior to discovery, diagnosis, and operation.

Contents 1 Rates 2 Mastectomy indications 3 Types of mastectomy 4 See also 5 References 6 External links

Rates

Mastectomy rates vary tremendously world-wide, as was documented by the 2004 'Intergroup Exemestane Study',^[1] an analysis of surgical techniques used in an international trial of adjuvant treatment among 4,700 women with early breast cancer in 37 countries. Exemestane (trade name Aromasin) is an oral Steroidal Aromatase inhibitor (but also known uniquely as an aromatase inactivator used in the adjuvant treatment The mastectomy rate was highest in central and eastern Europe at 77%. The USA had the second highest rate of mastectomy with 56%, western and northern Europe averaged 46%, southern Europe 42% and Australia and New Zealand 34%.

Mastectomy indications

Despite the increased ability to offer breast-conservation techniques to patients with breast cancer, there exist certain groups who may be better served by traditional mastectomy procedures including:

• women who have already had radiation therapy to the affected breast
• women with 2 or more areas of cancer in the same breast that are too far apart to be removed through 1 surgical incision, while keeping the appearance of the breast satisfactory
• women whose initial lumpectomy along with (one or more) re-excisions has not completely removed the cancer
• women with certain serious connective tissue diseases such as scleroderma, which make them especially sensitive to the side effects of radiation therapy
• pregnant women who would require radiation while still pregnant (risking harm to the fetus)
• women with a tumor larger than 5 cm (2 inches) that doesn't shrink very much with neoadjuvant chemotherapy
• women with a cancer that is large relative to her breast size
• Women who have tested positive for a deleterious mutation on the BRCA1 or BRCA2 gene and opt for prophylactic removal of the breasts
• male breast cancer patients

Types of mastectomy

There are a variety of types of mastectomy in use, and the type that a patient decides to undergo (or whether he or she will decide instead to have a lumpectomy) depends on factors such as size, location, and behavior of the tumor (if there is one), whether or not the surgery is prophylactic, and whether or not the patient intends to undergo reconstructive surgery.

• Simple mastectomy (or "total mastectomy"): In this procedure, the entire breast tissue is removed, but axillary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first axillary lymph node that the would be expected to drain into--is removed. The sentinel lymph node is the hypothetical first Lymph node or group of nodes reached by metastasizing Cancer cells from a Tumor. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure. Patients who undergo simple mastectomy can usually leave the hospital after a brief stay. Frequently, a drainage tube is inserted during surgery in their chest and attached to a small suction device to remove subcutaneous fluid. These are usually removed several days after surgery as drainage decrease to less than 20-30 ml per day. illustration

• Modified radical mastectomy: The entire breast tissue is removed along with the axillary contents (fatty tissue and lymph nodes). Radical mastectomy is a surgical procedure in which the breast underlying chest muscle (including Pectoralis major and Pectoralis minor) and Lymph nodes illustration

• Radical mastectomy (or "Halsted mastectomy"): First performed in 1882, this procedure involves removing the entire breast, the axillary lymph nodes, and the pectoral tissue behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall. illustration

• Skin-sparing mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). This aritcle is about the breast tissue For the Entomology term see Glossary of Lepidopteran_terms#Wings. The increased amount of skin preserved as compared to traditional mastecomy resections serves to facilitate breast reconstruction procedures. The skin is the outer covering of living tissue of an animal (or plant Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy. illustration

• Subcutaneous mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. The subcutaneous tissue or subcutis is the layer of Loose connective tissue directly underlying the Dermis. This procedure was historically done only prophylactically or with mastecomy for benign disease over fear of increased cancer development in retained areolar ductal tissue. Recent series suggest that it may be an oncologically sound procedure for tumors not in the subareolar position. ^[2][3][4]

See also

• Breast prosthesis
• Breast reconstruction
• Sex reassignment surgery female-to-male

References

External links

• Types of Mastectomy at mrbra. com
• Advice for Men with Breast Cancer at National Cancer Institute
• Mastectomy study at BBC
• When is a mastectomy not necessary? at center4research. The National Cancer Institute (NCI is part of the United States Federal government's National Institutes of Health. org
• Mastectomy summary at breastcancer. org
• Mastectomy article at eMedicine

eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors

© 2009 citizendia.org; parts available under the terms of GNU Free Documentation License, from http://en.wikipedia.org
Dapyx Software network: MP3 Explorer | Ebook Manager | Zenithic