Surgery for breast cancer (mastectomy): types and how it is done

Mastectomy is a surgical procedure for the removal of one or both breasts, which, in most cases, is indicated for people diagnosed with cancer, and can be partial, when only a part of the tissue is removed, total, when the breast it is removed completely or even radical, when, in addition to the breast, nearby muscles and tissues that may have been affected by the tumor are removed.

In addition, mastectomy can also be preventive, to reduce the risk of women developing breast cancer, or it can have an aesthetic purpose, in the case of surgery with masculinizing intent, for example.

Types of mastectomy

For each objective to be achieved with breast removal, a type of surgery can be performed, which is chosen by the mastologist or plastic surgeon, according to each case. The main types are:

1. Partial mastectomy

Also called a quadrantectomy or sectorectomy, it is a surgery to remove a nodule or benign tumor, with part of the surrounding tissue, without the need for total removal of the breast.

In this surgery, some nodes close to the breast may or may not be removed, to avoid the risk of the nodule returning.

2. Total or simple mastectomy

In total mastectomy, the mammary glands are removed completely, in addition to the skin, areola and nipple. It is best indicated in the case of a small tumor, discovered early and well located, without the risk of having spread to surrounding regions.

In this case it is also possible to remove or not nodes in the armpit region, to reduce the risk of the tumor coming back or spreading.

3. Radical mastectomy

In radical mastectomy, in addition to the removal of the entire breast, the muscles located under it and the ganglia in the armpit region are also removed, being indicated for cases of cancer with risk of dissemination.

There are variants of this surgery, known as Patey's modified radical mastectomy, in which the major pectoral muscle is maintained, or Madden's modified radical mastectomy, when both the major and minor pectoral muscles are preserved.

4. Preventive mastectomy

Preventive mastectomy is done to prevent the development of cancer, and is indicated only for women with a very high risk of this disease, such as those who have an important family history or who have genetic changes that can cause cancer, known as BRCA1 and BRCA2. Know when to do genetic testing for breast cancer.

This surgery is done in a similar way to total or radical mastectomies, being removed the entire breast, nearby ganglia and, in some cases, the surrounding muscles. Generally, bilateral surgery is performed, because in these cases, the risk of developing cancer is similar in both breasts.

5. Other types of mastectomy

Male or masculinizing mastectomy is a type of plastic surgery done with the aim of giving a male appearance to a woman's chest. Thus, in this surgery, the breast is removed, which can be by different techniques, decided by the plastic surgeon, depending on the size and type of each woman's breasts.

Mastectomy can also be performed in cases of breast cancer in men, which happens more rarely, and surgeries are performed in the same way as in women, although men have much less glands.

There are also cosmetic breast surgeries known as mammoplasty, which can be used to reduce, increase or improve the appearance of the breasts. Find out what breast plastic surgery options are.

Mastectomy Price

The price of the surgery can vary from R $ 10, 000.00 to R $ 20, 000.00, depending on the type of surgery and the location performed.

How is the postoperative

Breast removal surgery is a surgery lasting about 60 to 90 minutes, with spinal or general anesthesia.

Recovery after the procedure is rapid, and it may take 1 to 2 days of hospitalization, depending on the type of surgery and whether it was bilateral or unilateral.

A drain can be left, so that the secretion produced in the first days after the procedure is removed, which must be attached and well accommodated to the clothes so that it is not accidentally pulled. This drain should be emptied about 2 times a day, with a note of the amount drained to inform the doctor at the return visit.

In addition, some recommendations that must be followed in the postoperative period are:

Take analgesic or anti-inflammatory medications, prescribed by the doctor, in case of pain; Go to the return visit, usually scheduled after 7 to 10 days of the procedure; Do not take weight, drive or exercise during this period or until medical clearance; Contact the doctor in case of fever, severe pain, redness or swelling at the surgery site or in the arm on the operated side;

In surgeries with removal of the lymph nodes, the circulation of the corresponding arm can be compromised, and it becomes more sensitive, being important to protect it well from injuries, burns and avoid excessive efforts.

After the procedure, it is still important that the treatment is continued with physiotherapy, which will help to improve the movements of the arms, circulation and reduce the contractures caused by healing. See more details on recovery after breast removal.

How and when breast reconstruction is performed

After performing any type of mastectomy, breast reconstruction surgery may be necessary to restore the natural shape of the breasts. It can be done immediately after the procedure or in stages, with gradual correction of the region, but, in many cases of cancer, it may be necessary to wait some time for complete healing or after exams to confirm the complete removal of the malignant cells.

See more about how breast reconstruction is done.

Breast reconstruction

Who should have a mastectomy

Mastectomy can be performed when:

The woman is at high risk of developing breast cancer (preventive mastectomy); It is necessary to complement the radiotherapy and chemotherapy treatment for breast cancer; One can prevent breast cancer in the other breast, when the woman has already had cancer in one breast; The woman has carcinoma in situ , or located, discovered early to prevent the progression of the disease; There is a desire to remove the breasts, as in masculinizing mastectomy.

Thus, it is important that the woman consults the gynecologist annually for preventive evaluations, or whenever symptoms appear that may indicate the presence of a breast tumor, such as the presence of a lump, redness or the presence of secretion in the breasts. Learn to recognize the main symptoms of breast cancer.