A Guide To Mastectomy Surgery At Any Age

MASTECTOMY

Mastectomy is a surgery to remove all breast tissue from breast, a way to treat/prevent breast cancer. In early stage of breast cancer, lumpectomy is used to remove the tumor from breast. Mastectomy can be a secondary option.  

Mastectomy and lumpectomy are difficult. Both procedures are effective to prevent the recurrence of breast cancer. Lumpectomy is not for everyone with breast cancer, others prefer to go mastectomy. The breast reconstruction is done to restore the shape of breast. It can be done at same time during mastectomy or in second operation.

Why its required?

A mastectomy is performed to remove the breast tissues, if breast cancer is in developing stage.

Mastectomy may be the treatment option for many types breast cancer-

·        Early stage of breast cancer.

·        Stage 3 breast cancer.

·        Recurrent breast cancer.

Surgery

Mastectomy is the removal of breast completely. There are different types of mastectomy. They are listed below-

·        Total Mastectomy-

          The surgeon will completely remove the breast. Surgeon will not perform lymph node dissection. Sometimes lymph nodes are removed, since they are located within the breast tissue take during surgery. Muscles are not removed from beneath the breast. It is for women who are having multiple or large area of ductal carcinoma in situ(DCIS).

·        Modified Radical Mastectomy-

          It involves removal of breast tissue and lymp nodes. Surgeon removes the complete breast. Auxillary lymp node dissection is done during which level 1 and 2 of underarm lymph nodes are removed. Beneath the breast no muscles are removed. People with invasive breast cancer who wants to go for mastectomy will get modified radical mastectomy, so that  lymph node can be examined.

·        Radical Mastectomy-   

          The surgeon will remove the complete breast . Level 1,2 and 3 of underarm lymph nodes will also be removed. The chest wall muscles will be also removed. It is recommended when cancer spread to chest muscles under breast.

During the procedure:

The procedure is performed under general anesthesia. The surgeon will make an elliptical cut around breast. The breast tissue is removed and depending on procedure, other part of breast can also be removed.

The breast tissue and lymph node are removed and sent to lab for analysis.

If breast reconstruction is to be performed during mastectomy, a plastic surgeon will accompany the breast surgeon.

People who will go for radiation therapy after surgery, a temporary tissue expander is placed in chest to hold breast skin in place.

After the surgery is completed, the cut is closed with stitches which will dissolve after sometime. You may also have one or two plastic tube placed where breast was removed. The tubes will help in draining any fluids that comes out after surgery. Tubes are sewed in place and ends are attached to small drainage bag.

Risks

·        Infection.

·        Bleeding.

·        Pain.

·        Swelling in arm.

·        Shoulder pain.

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What Everyone Must Know About Club Foot

Clubfoot

The Clubfoot occurs when the foot and ankle are twisted permanently. In clubfoot, the ligament and tendons which holds the muscles to bones very tight. It is a congenital deformity.

Clubfoot is classified in two groups:

·        Isolated clubfoot: It is very common form of deformity and occur to children who have no medical issues.

·        Non-isolated clubfoot: It occurs in combination with various health condition.

The cause of clubfoot is not clear, it may be the combination of genes and environment.

Symptoms

·        Affected leg may be shorter.

·        Calf muscles in affected leg is under developed.

·        Top of foot is twisted downward and inward.

Treatment

          An orthopedic surgeon is recommended for the surgical treatment to correct bone structure of foot. There are non-surgical and surgical treatment for clubfoot.

Non-surgical Treatment-

Ponseti Method:  It is a widely used technique throughout the world. In this method a gentle stretching and casting is done to correct the deformity.

The elements of ponseti method includes:

1. Manipulation and casting- The baby's foot is stretched and manipulated to correct position and held in place with long legged cast. Every week the process of stretching, re-position, and casting is repeated till the foot is improved. The improvement takes about 6 to 8 weeks.  

2. Achilles tenotomy-  After going through manipulation and casting, 90 percent of babies need minor procedure to release tightness. For this a quick procedure is performed, doctor will take a thin instrument to cut tendon. The cut is very small and will not require stitches. New cast will be applied to protect the tendon during healing process. It takes about 3 weeks to heal. By the time cast is removed, the achilles tendon regrow to proper length and clubfoot is cured.

3. Bracing- After successful correction, the clubfoot can recur. To ensure, foot is completely corrected, baby will have to wear braces for few years. The brace will keep the foot at correct angle to maintain correction.

4. Considering Ponseti Method- The ponseti method is extremely effective for most of the children . It require high commitment from family to apply the braces properly every day.

Surgical Treatment

          The child's foot is partially corrected with stretching and casting, then to fully correct the clubfoot, following kind of surgery-

          1. Less extensive surgery- It will target those tendon and joints which are helping in deformity. This include releasing of tendon at back to inside of mid foot.

          2. Major reconstructive surgery- It involve extensive release of multiple soft tissue structure of foot. Once the correction is made, joints of foot are stabilized with pins and long-leg cast while the soft tissue heals. After 4-6 weeks doctor will remove pins and cast. A short leg cast is applied, which has to be worn by the child for 4 weeks. When the cast is removed, there is still chance of club foot to return, s special shoes are used for a year after surgery.    

 

Risks

·        Genes.

·        If mother smokes during pregnancy.

·        If you have spina bifida or other spinal injuries.

-SurgeryXchange is an online platform for medical second opinions and advisory services for hospital admission.

  To know more click here.