surgical treatment mastectomy
mastectomy
A mastectomy means that all the breast tissue is
removed. Some women prefer to have a mastectomy for personal reasons,
even if their doctor thinks they are suitable for a partial mastectomy.
This decision will always be respected.About 30% of women are not suitable for breast conserving surgery. This may be because:
- The tumour is too big in relation to the breast and a partial mastectomy would lead to a poor cosmetic result
- There is more than one cancer in different parts of the breast (multifocal)
- There would be problems giving post-operative radiotherapy (some medical conditions or previous radiotherapy)
A new breast can be reconstructed at the time of surgery or at a later date (see breast reconstructive surgery). If immediate breast reconstruction is to be performed, as much skin as possible is kept (skin sparing mastectomy)to obtain a more natural looking reconstructed breast.
Recovery time
Everyone recovers from an operation at different rates. Minimum time off work would be seven to ten days. More realistically, two to three weeks should be taken off before returning to work. Stay in hospital is usually one to two nights.
Wound Care
If you leave hospital after only one night you will have a thick pressure bandage over the breast. This can be removed two days after the operation and a light dry dressing can be applied and changed as required. The surgeon uses layers of dissolving stitches under the surface. Consequently there is very little tension on the skin layer therefore steristrips (little paper sticky tapes) are used to close the skin incision. These steristrips should be left untouched and dry for a week. It is important to keep the area dry for one week following the operation. If you inadvertently get it wet, dry the area off with a hairdryer and re-apply a clean dry dressing. Once the wound has healed (one week after the operation) the steristrips are removed. Micropore tape should be placed over the breast scar for four to six weeks and changed as required, perhaps twice a week. This ensures that the skin edges 'knit' together and achieves a better cosmetic result. You do not have to keep changing the tape after bathing as it can dry on the skin.
Complications
Only one or two women in every 100 will develop a post-operative complication such as a wound infection or haematoma (bleeding into the wound). If an infection develops the area will become painful, red and swollen. If there is bleeding into the wound the area will become swollen and painful. A seroma, which is a collection of straw coloured fluid, is common after mastectomy. This will generally improve on its own as the body develops new channels for the fluid. If it is troublesome, the excess fluid can be easily drained with a needle. Generally you should expect comfort levels to improve each day and if for any reason the reverse happens notify St Marks Breast Centre. Most complications are easily treated.
Radiotherapy
Occasionally radiotherapy is required for women who have a mastectomy. The 'Rule of Five' applies - radiotherapy begins usually about five weeks following the operation for five working days for five weeks for about five minutes a day. The radiotherapy 'sterilises' the chest wall tissue. Your surgeon and oncologist will talk to you about this once the histology report has been received.