Mastectomy is the removal of all breast tissue to treat or prevent breast cancer. Depending on the pathology of the breast cancer, either the skin envelope is left (skin sparing mastectomy) or the majority removed (radical modified mastectomy). A skin sparing mastectomy is the procedure of choice for those who are able to oncologically preserve the nipple-areolar complex, and also prefer an immediate breast reconstruction.
For those with early breast cancer, a mastectomy is one treatment option, however breast conserving surgery where the tumour with a margin of normal tissue (lumpectomy) is removed, followed by radiation therapy, may be another option.
Indications to have a Mastectomy
- Proportionally large tumour size or multiple tumours, be it invasive carcinoma disease, ductal carcinoma in situ, inflammatory breast cancer, recurrent breast cancer
- To avoid radiation post operatively.
- Patient preference.
- Small breast size where a wide local excision and radiation would not be an aesthetically good outcome.
- Prophylactically – to reduce the risk of developing a cancer in that breast by 98%. This is a consideration in patients with a strong family history of breast cancer, BRCA positive or other high risk gene mutation positive patients, lobularbreast cancer diagnosis (as it tends to occur in both breasts).
Incision
Modified Radical mastectomy – Slight diagonal across chest wall as low as the cancer position will allow.
Skin sparing mastectomy:
- Inframammary fold (lower breast crease where the breast meets the abdomen).
- Periareolar (around the areolar margin).
- Over the tumour site.
- Inverted T – If there is a very large and/or ptosed (droopy) breast with excessive skin envelope
Before and After
Pre operative mastectomy
Post operative skin-sparing mastectomy with reconstruction
Potential Complications
Bleeding
- Wound infection/breakdown
- Seroma (fluid collection)
- Keloid scars especially in Asia, Indian African and Mediterranean descent.
- Nipple-areolar loss (partial or full) with poor blood supply or venous drainage in skin sparing mastectomies
What’s the next step?
The next step is to book a consultation with our qualified team.
You can book your treatment online or call our friendly team on 03 9041 8445.
Details
Procedure:
Performed under General Anaestheisa.
Time in Surgery:
- Ranges from 1-2 hours per breast (without reconstruction).
- 1-2 drains depending on whether an axillary clearance has occurred.
Time in Hospital:
- Ranges from 3-5 days.
- If patient is suitable, may be discharged with drains insitu and time in hospital is 1-2 days.
Post Operative Care:
- No driving for 2-3 weeks
- No heavy lifting for 4 -6 weeks