Womens Health Problems - Mastectomy is the medical term for surgical removal of one or both breasts, can be partially or entirely. Mastectomy usually done as a therapy for breast cancer; in some cases, women and some men believed to perform better surgery profiksasis (prevention) rather than at a higher risk for developing breast cancer. Mastectomy is also a medical procedure to remove breast cancer for male patients.
Treatment of breast cancer in yore is to lift the breast as a whole. Lately, the decision to perform mastectomy be considered based on these factors, among others: the size of the breast, the amount of mass (lump), keagresifitasan of breast cancer cells, the effects of radiation therapy, and patient willingness to accept a higher risk of recurrence rates after lumpectomy and radiation done.
Indications done mastectomy :
- Women who have received radiation therapy to the affected breast.
- Women with cancer in two or more areas in one breast at a distance that is too far away to be lifted with a single incision (incision).
- Women who had previously undergone a lumpectomy along with re-excision to remove the cancer but not in its entirety.
- Women who have abnormalities or disease in tissue binding, such as scleroderma, where it makes the sufferer, in particular, sensitive to the effects of radiation therapy.
- Pregnant women who still require radiation therapy during her pregnancy, which if done would be harmful to the fetus.
- Women who had tumors with diameters larger than 5 cm that can not be narrowed with additional therapies such as chemotherapy.
- Women with cancer whose size is relatively larger than the size of her breasts.
- Women who tested positive in removing mutations (deleterious mutation) in BRCA1 or BRCA2 gene and are willing to do prophylactic breast removal surgery.
- Men who have breast cancer.
Many types of mastectomy type used on lately and what type dikerjakakan in a patient will be decided based on several factors, for example: size, location, behavior of the tumor itself (if more than one), whether it is prophylactic surgery or not , and whether the patient wants breast reconstruction surgery or not. The types of mastectomy :
- Simple Mastectomy (Total Mastektomy): In this surgical procedure, the overall breast tissue removed, but the lymph nodes under the armpit (axillary lymph nodes) are not lifted. Sometimes the sentinel lymph node, which is the major lymph nodes, which lags associated with breast removed as well. To identify the sentinel lymp node surgeon will inject a liquid and / or radioactive tracer into the area around the nipple. Fluid or tracer were going to point-point flow of lymph nodes, the first will get to the sentinel lymp nodes. Surgeons will find the points on the KGB (lymph nodes) a different color (if used fluid) or radiation (when using a tracer). This method will typically have a lower risk of lymphedema (swelling of the arm) than the axillary lymp node dissection. If the sentinel node is free, but the result of the spread of cancer, then no further operations to the KGB. If otherwise, then followed the surgical removal of the KGB. This operation is sometimes performed on both breasts in patients who wish to undergo mastectomy as a cancer preventive considerations. Patients who undergo simple mastectomy can usually leave the hospital after being treated briefly. Often, drains inserted during surgery in the patient's chest and using a vacuum (suction) to remove small subcutaneous fluid (the fluid under the skin). These tools are usually removed several days after surgery if the drainage has been reduced from 20-30 ml per day.
- Modified Radical Mastectomy: The entire breast tissue is removed along with the existing networks under the armpit (lymph nodes and fat tissue). In contrast to simple mastectomy, m. pectoralis (pectoralis muscle) abandoned.
- Halsted Radical Mastectomy or Mastectomy: first shown in 1882, this surgical procedure involves removing the entire breast tissue, lymph nodes under the armpit, and m. pectoralis major and minor (under the breast). This procedure is more ugly than the modified radical mastectomy and no benefits in most tumors to survive. This operation, currently more used for tumors that involve the m. pectoralis major or recurrent breast cancer involving the chest wall.
- Skin-sparing Mastectomy: In this surgery, breast tissue is removed with a slice of the conservative (conservative incision) made mengeliligi areola (dark area around the nipple). An increasing number of areas of skin that tersis when compared with traditional mastectomy, can facilitate the procedure of breast reconstruction (breast reconstruction surgery). Patients with skin cancer that also involves pda breasts, not just for the use of this surgical procedure.
- Subcutaneous Mastectomy: breast tissue removed, but the nipple area (nipple-areola complex) abandoned. This procedure is done only in history as a prophylactic mastectomy in tumors or with benign feared could develop into cancer in the area around the nipple.