Mastectomy, << mas TEHK tuh mee, >> is the surgical removal of a breast. Surgeons generally perform a mastectomy to treat women for breast cancer. The operation removes cancer cells in the breast and prevents them from spreading to other body organs.
There are four main types of mastectomies. The type of mastectomy performed depends on the size and location of the tumor, the extent of the cancer, and the age and health of the patient. The conventional radical mastectomy removes the breast, the lymph nodes in the underarm, and the chest wall muscles. The modified radical mastectomy removes the breast and the underarm lymph nodes. A simple mastectomy, also called total mastectomy, removes only the breast. A subcutaneous mastectomy removes breast tissue but spares the overlying skin and nipple.
William S. Halsted, an American surgeon, developed the conventional radical mastectomy in 1894. It remained the most common surgery for breast cancer until the 1970’s. This operation leaves a long scar and hollow areas where chest muscle is removed. It often limits use of the arm. By the late 1970’s, studies showed that modified radical mastectomy, which causes less deformity than the conventional surgery, treated cancer just as effectively. Today, the modified radical is the most common surgery for breast cancer. It leaves enough tissue for reconstruction and preserves use of the arm.
Most mastectomy patients wear an artificial breast called a prosthesis. Some women have the breast reconstructed surgically. Surgeons may replace the breast using tissue from other parts of the body. In other cases, surgeons insert an implant filled with salt water or a material called silicone gel under the chest muscle. In 1992, the United States Food and Drug Administration limited use of silicone gel implants to women enrolled in studies to determine if these implants caused health problems. Results of studies in the mid-1990’s convinced most doctors that silicone implants rarely cause harm.
When a breast cancer is small, a lumpectomy may preserve the breast. This operation removes the cancerous tumor, a margin of normal tissue, and the underarm lymph nodes. The breast is then treated with radiation to kill any remaining cancer cells. Major studies in the 1980’s and 1990’s showed that lumpectomy with radiation is as effective as mastectomy in treating small cancers.
