The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 12 Jun 2013 03:48 AM PDT Learn more about the breast removal surgery known as mastectomy. I READ with interest Angelina Jolie's decision to have a double mastectomy. While I understand why she did it – to prevent herself from getting breast cancer because she has the deadly breast cancer genes – I am very scared when I imagine having to remove both my breasts. What is a mastectomy and how much of the breast tissue does it really remove? A mastectomy is a type of surgery to remove the whole breast. There are five different types of mastectomy: > Simple or Total Mastectomy: The entire breast is removed, but there is no removal of the axillary lymph nodes in your armpit. No muscles are removed from your chest wall underneath the breast. This is usually performed for women with multiple or large areas of breast cancer that does not involve the lymph nodes, known as ductal carcinoma in situ. It is also performed for women like Angelina Jolie who do not have breast cancer, but have a high risk of getting the condition. > Modified Radical Mastectomy: This involves removal of both the breast tissue and axillary lymph nodes. But no muscles are removed from the underlying chest wall. Most people with breast cancer will have this type of mastectomy so that the axillary lymph nodes can be taken out and examined for cancer cells. If there are cancer cells in the lymph nodes, this means that the cancer has spread beyond the breast. > Radical Mastectomy: This is the most extensive type of mastectomy. Here, the entire breast, axillary lymph nodes, and also, the chest wall muscles beneath the breast are removed. This type of mastectomy is done only when the breast cancer has spread to the chest muscles below it. It is now rarely performed because the modified radical mastectomy is just as effective and less disfiguring. > Partial Mastectomy: This involves the removal of the cancerous part of the breast tissue and some normal tissue around it. > Subcutaneous (nipple-sparing) Mastectomy: All of the breast tissue is removed here, but the nipple is spared. Most surgeons do not like to perform this because they fear the breast tissue that is left may develop cancer later. Will the entire skin of my breasts be removed as well? There is such a procedure called skin-sparing mastectomy. It "spares" as much of your breast skin as possible so that you can have immediate breast reconstruction. Here, the surgeon only removes the skin of your nipple, areola and the biopsy scar, if any. Then the breast tissue is removed from a small opening that is created. Your remaining skin will provide the pouch for which an implant for reconstruction can be made. Most women choose this type of surgery so that they can have immediate breast reconstruction. But if it is suspected that you have cancer cells very near the skin, this surgery is not recommended. If I have breast cancer, must a mastectomy always be done? No. There is another type of breast surgery called a lumpectomy. It removes the breast tumour ("lump") and some normal tissue surrounding it. It is technically a partial mastectomy, but it is the lesser amount of tissue removed which differentiates the two. For breast cancer beyond Stage 1, this is usually followed by radiotherapy and chemotherapy to help eliminate any remaining tumour cells, which may have possibly settled. Do note that tadiotherapy and chemotherapy are not treatments that are only reserved for Stage 4 cancer. What is breast reconstruction? Is it possible for me to have a "new" breast once I have had a mastectomy performed? Yes. Some women want to have their breast reconstructed or rebuilt during the same operation that removes it. This is known as "immediate reconstruction". Other women wait months or years before having their breast reconstructed. There are several ways to reconstruct a breast: > By inserting an implant, which is usually filled with salt water or silicone gel, or a combination or the two. > Using your own tissue taken from another part of your body, such as your abdomen, thighs or back. This is called autologous implantation. This method may be augmented by a salt water/silicone implant, in case you don't have enough tissue to furnish your breast. If you need radiotherapy and chemotherapy, it is recommended that you complete them before having a breast reconstruction, as they may alter the appearance and feel of the construct. Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. For further information, e-mail starhealth@thestar.com.my. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information. |
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