Types and Procedure of Radical Mastectomy | Oncology

Radical Mastectomy

What is a radical mastectomy?

During a radical mastectomy, the surgeon removes all of the breast tissue along with the nipple, lymph nodes in the armpit, and the muscles in the chest wall below the breast. This way is rarely performed today, because modified radical mastectomy, a less general surgery, has been shown to be equally effective, less disfiguring, and does not carry the risk of secondary angiosarcoma associated with this type of surgery.

The choice of mastectomy will depend on the clinical setting. You should thoroughly discuss your surgical options with your surgeon to achieve the best result. Either type of surgery is your best option; you will be able to return home after a short stay in the hospital.

Types of radical mastectomy

There are several different techniques for an adapted radical mastectomy, counting simple or total mastectomy, skin-sparing mastectomy, nipple-sparing, sentinel lymph node biopsy, and/or axillary lymph node dissection.

Modified radical mastectomy procedure

The overall goal of an MRM procedure is to remove all or most of the cancer present while preserving as much healthy skin tissue as possible. This makes effective breast reconstruction possible after it has healed properly.

For an adapted radical mastectomy, you will be placed under general anaesthesia. Then your doctor will mark your chest to prepare it for the incisions. By making an incision through your chest, your doctor will carefully pull your skin back enough to remove the breast tissue. They will also remove most of the lymph nodes under the arm. The entire procedure typically takes two to four hours.

Once removed, the lymph nodes will be examined to see if cancer has spread to them or through them to other areas of the body. Your doctor will also place thin plastic tubes in your breast area to drain excess fluid. They can stay on your chest for up to a week or two.

Complications

As with any surgical way, MRM can cause a number of complications. The risks of this procedure contain:

  • Pain or tenderness
  • Bleeding
  • Swelling in the armour at the incision site
  • Limited arm movement
  • Numbness
  • Seroma (accumulation of fluid under the wound site)
  • Hematoma (accumulation of blood in the wound)
  • Scar

What to expect after surgery?

Recovery times vary from person to person. Typically, people stay in the hospital for a day or two. In some cases, your doctor may recommend radiation therapy or chemotherapy after your mastectomy procedure.

At home, it is significant to keep the surgical area clean and dry. You will be given specific instructions on how to care for the wound site and how to bathe properly. Pain is normal, but the amount of discomfort you experience can vary. Your physician may recommend pain relievers, but only take what is prescribed. Some pain relievers can cause complications and slow down your healing process.

Lymph node removal can make your arm feel stiff and sore. Your doctor may recommend certain exercises or physical therapy to increase movement and prevent swelling. Perform these exercises slowly and regularly to avoid injury and complications. If you start to feel more discomfort or if you notice that you are healing at a slower rate, schedule a visit with your doctor.

Modified radical mastectomy versus radical mastectomy

Similar to the MRM procedure, a radical mastectomy involves removing the entire breast: the breast tissue, the skin, the areola, and the nipple. However, this procedure also involves the removal of the chest muscles. Radical mastectomy is the most invasive procedure and is only considered if a tumor is found that has spread to the chest muscles.

Once performed as a more common treatment for breast cancer, radical mastectomy is now rarely used. Modified radical mastectomy has established to be a less invasive procedure with similarly effective results.

Who usually undergoes a modified radical mastectomy?

People whose breast cancer has spread to the axillary lymph nodes who decide to have a mastectomy may be recommended to undergo the MRM procedure. MRM is also obtainable for patients with any type of breast cancer where there may be a reason to eliminate the axillary lymph nodes.

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