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Mastectomy Surgery in India

Overview

A Mastectomy Surgery is the oldest procedures performed for patients suffering from breast cancer. Before the development of the lumpectomy and Quadrantectomy, a mastectomy was only surgery for this disease. A mastectomy removes the entire breast and may include the removal of skin and muscle. Mastectomy is surgery to remove breast tissue. The breast may be removed because of cancer or fibrocystic disease. The Mastectomy performed in central and eastern Europe at 77%, which is the highest in the world. The USA comes second with 56%, western and northern Europe averages to 46%, southern Europe 42% and Australia and New Zealand 34%. The Mastectomy Surgery is referred to as "local therapies" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

What is Mastectomy Surgery?

Mastectomy Surgery is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it. It is also the medical procedure carried out to remove breast cancer tissue in males. Mastectomy is what is referred to as "local therapy" for breast cancer, targeting the area of the tumor, as opposed to systemic therapies such as chemotherapy, hormonal therapy, or immunotherapy.

Am I the Candidate for Mastectomy Surgery?

Mastectomy Surgery may be the right choice for you if the following is true for you:

If the tumor is larger than 5 centimeters, you will probably need a mastectomy. Depending on stage and other factors, some tumors smaller than 5 centimeters may still require mastectomy, although others may be addressed by lumpectomy.

If your breast is small and a lumpectomy would leave you with very little breast tissue, your doctor may advise you to have a mastectomy.

If your surgeon has already made multiple attempts to remove the tumor with lumpectomy, but has not been able to completely remove the cancer and obtain clear margins, you may need a mastectomy.

If lumpectomy plus radiation is not an option for your small tumor (for example, under 4 centimeters) because you have had prior radiation to the same breast, you have a connective tissue disease (lupus, rheumatoid arthritis), you are pregnant, or you do not want to commit to daily radiation treatment, you may need to have a mastectomy.

If you believe mastectomy would give you greater peace of mind than lumpectomy, you might decide to have a mastectomy.

How is the Diagnosis for Mastectomy Surgery Performed?

A Mammogram is performed, it is usually ordered to verify the size of the lump the patient has reported. A biopsy of the suspicious lump and/or lymph nodes is usually ordered and sent to the pathology lab before surgery is discussed. A Mastectomy Surgery comes with tests like the preoperative tests as blood work, a chest x ray, and an electrocardiogram. A Breast MRI is also performed which uses a strong magnet to create a detailed image of a part of the body. It does not use x-rays or radiation. Breast MRI may be recommended to aid in the diagnosis of breast cancer in selected situations.

What are the Types of Mastectomy Surgery?

There are a variety of types of mastectomy in use, and the type that a patient decides to undergo (or whether he or she will decide instead to have a lumpectomy) depends on factors such as size, location, and behavior of the tumor (if there is one), whether or not the surgery is prophylactic, and whether or not the patient intends to undergo reconstructive surgery.

Simple Mastectomy: (or "total mastectomy") is a procedure where the entire breast tissue is removed, but auxiliary contents are undisturbed. Sometimes the "sentinel lymph node"--that is, the first auxiliary lymph node that the metastasizing cancer cells would be expected to drain into is removed. This surgery is sometimes done bilaterally (on both breasts) on patients who wish to undergo mastectomy as a cancer-preventative measure.

Modified Radical Mastectomy: The entire breast tissue is removed along with the auxiliary contents (fatty tissue and lymph nodes). In contrast to a radical mastectomy, the pectoral muscles are spared.

Radical Mastectomy: (or "Halsted mastectomy") is the procedure which involves removing the entire breast, the auxiliary lymph nodes, and the pectoralis major and minor muscles behind the breast. This procedure is more disfiguring than a modified radical mastectomy and provides no survival benefit for most tumors. This operation is now reserved for tumors involving the pectoralis major muscle or recurrent breast cancer involving the chest wall.

Skin-sparing Mastectomy: In this surgery, the breast tissue is removed through a conservative incision made around the areola (the dark part surrounding the nipple). The increased amount of skin preserved as compared to traditional mastectomy resections serves to facilitate breast reconstruction procedures. Patients with cancers that involve the skin, such as inflammatory cancer, are not candidates for skin-sparing mastectomy.

Nipple-sparing/Subcutaneous Mastectomy: Breast tissue is removed, but the nipple-areola complex is preserved. This procedure was historically done only prophylactically or with mastectomy for benign disease over fear of increased cancer development in retained areola ductal tissue. Recent series suggest that it may be an ontologically sound procedure for tumors not in the subareolar position.

Subcutaneous Mastectomy: The tumor and breast tissue are removed, but the nipple and the overlying skin are left intact. Reconstruction surgery is easier, but some cancer cells may remain.

Partial Mastectomy: In a partial mastectomy, a larger amount of breast tissue and some skin are removed with the tumor. A partial mastectomy also includes removal of the lining over chest muscles below the tumor and, usually, some lymph nodes. This surgery is usually performed for Stage 1 and 2 tumors.

Lumpectomy: In a lumpectomy, the tumor and a small amount of surrounding tissue are removed. Several lymph nodes may also be removed

How to Prepare for Mastectomy Surgery?

The time leading up to the Mastectomy Surgery is often the most angst-ridden, as questions loom large and waiting takes its toll. Questions are valid, and every concern is justified. Keeping it all in perspective - and understanding that it is not the end of the world - is the key to powering through. Remember thousands of women have gone through the very same thing, and have come out stronger on the other side. Losing a breast is hard, but if it is going to save your life it is well worth it. Be thankful the cancer happened in a part of your body that is removable. This may sound extremely callous, but this is all about perspective, right?

Expect to have several tests to prepare for a Mastectomy Surgery. Tests will likely include a routine blood work, urinalysis and an ECG (electrocardiogram). This will identify underlying infections, abnormalities or heart irregularities that could cause increased risk for surgery.

Prepare to ask the anesthesiologist questions about the anesthesia during the surgery. Ask about the method used to make sure you will remain anesthetized during the procedure. While it is extremely rare, some patients are able to feel the surgery in progress but are unable to alert the doctor.

Notify your doctor and anesthesiologist if you are taking any medications, including herbal supplements. Some supplements and medications can increase the risk of bleeding, and these must be stopped prior to surgery. Only your doctor can determine what is safe to take prior to and immediately following surgery.

Plan to go without anything to eat or drink for 8 hours or more prior to the time of surgery. The stomach must be empty during surgery to reduce the chance of regurgitation of stomach contents into the lungs.

Anticipate that showering with an antibacterial soap the evening before surgery may be necessary. This reduces the contaminants on the body that could cause infection in the open incision.

Read the surgical consent form completely and carefully. Make sure it states the appropriate surgery in the correct location. It should state which breast and give a complete description of the surgery. For instance, "total mastectomy, right (or left) breast" is required over "mastectomy."

Determine who will be available to assist you with home duties after release from the hospital. There will be restrictions on lifting and some movements during recovery. This is especially necessary if small children are in the home.

What are the Common Procedures of Mastectomy Surgery?

Total Mastectomy: is a procedure that removes all of the breast tissue of the affected breast. The most common form of the surgery, referred to as traditional total mastectomy, includes the removal of the areola and nipple. However, the surgery can be performed using skin and nipple sparing techniques. It also leaves the muscle under the breast left intact. The procedure is performed using an elliptical incision 6 to 8 inches in length that begins on the inside of the breast, near the breast bone, and extends upward and outward toward the armpit. The incision can also be altered to remove scar tissue from previous procedures, which can improve the cosmetic outcome if reconstruction is desired. Once the breast tissue is removed, the incision is closed with either absorbable sutures, which the body slowly absorbs over time, or staples that are removed during an office visit 10 to 14 days after surgery. There may also be a drain, a device that helps remove excess fluid from the body to promote healing and decrease swelling, in place. The drain will be under a bandage to protect the surgical site and the drain placement. In most cases, the drain will be removed during an office visit after discharge from the hospital.

Radical Mastectomy:A less common type of mastectomy which was used very often up until recently is the modified radical mastectomy, in which all of the auxiliary contents and lymph nodes are removed in addition to all of the breast tissue. Like other types of mastectomy, a radical mastectomy removes all of the breast tissue of the affected breast. It also removes all of the lymph nodes under the arm on the affected side and the muscle that lies under the breast. Only the skin required to close the incision is left in place. This procedure is not considered necessary for patients whose cancer has not invaded the muscle. This surgery is considered the most disfiguring of the mastectomy procedures, leaving very little tissue other than skin over the rib bones. The scar left after this surgery is 6 to 8 inches long, with enough skin left to close the incision with sutures or staples. The surgeon may also place drains in the areas of surgery which, as in the other procedures, will be covered for protection and then later removed by the surgeon during a routine office visit.

Skin-Sparing Mastectomy: The procedure that is becoming more common over the past ten years is the skin-sparing mastectomy, where the breast is removed through a cut in the areola of the nipple. This is not a recommended procedure if you also have skin cancer, but provides minimal scarring and the possibility of breast reconstruction if desired. Skin-sparing mastectomy is a technique that preserves as much of the breast skin as possible. Skin-sparing mastectomy can be performed as a "simple" or "total" mastectomy or as a modified radical mastectomy to provide the skin needed for immediate reconstruction. During skin-sparing mastectomy, the surgeon removes only the skin of the nipple, areola, and the original biopsy scar. Then the surgeon removes the breast tissue through the small opening that is created. The remaining pouch of skin provides the best shape and form to accommodate an implant or a reconstruction using your own tissue. Many women choose this type of mastectomy in order to get the most realistic and pleasing results from immediate breast reconstruction.

What is the Post-operative Care following a Mastectomy Surgery?

Many women experience physical and emotional changes as result of a Mastectomy Surgery. This is the first in a four-part series of articles designed to help women with breast cancer understand common issues faced after treatment. The necessary follow-up care after a mastectomy depends on a woman’s overall health and how much tissue the doctor removed. For example, a woman who has had a radical mastectomy may need more time to recover. It is important to review all follow-up care instructions with your doctors and caregivers. Be sure you understand instructions on the following topics:

• Wound and bandage care
• Drainage care
• Warning signs of infection
• When to call the doctor
• Nutritional needs during recovery
• Medications and pain control
• Activity restrictions
• Clothing restrictions (for example, when a bra or prosthesis can be worn)

How is the Recovery of Mastectomy Surgery?

For obvious reasons, patients should not expect recovery from a Mastectomy Surgery to be a simple process. In fact recovery may take approximately three to six weeks. Some patients experience symptoms such as slight swelling for up to six months after the procedure is performed.

Compression bandages and drains are usually part of the mastectomy recovery process. Compression bandages are routinely applied to mastectomy patients once the procedure is completed. The patient wears these bandages for one to two weeks before switching to compression garments which serve a similar purpose. Additionally, many mastectomy patients have drains inserted to facilitate the removal of fluids around the surgery site. This helps to prevent complications such as swelling, bleeding and bruising.

Patients recovering from a mastectomy procedure will likely be able to return to work after approximately one week assuming the work is not physical in nature. The patient may have limitations on physical activities for approximately the first six weeks after the surgery. After this point most patients are fully recovered, although some patients may experience minor swelling that persists for as long as six months.

During Mastectomy recovery, patients might undergo psychological treatments. It's likely if the patient is having a difficult time dealing with the loss of the breast. This is common as many women find a mastectomy to be traumatic. This is often true for women who have not had a breast reconstruction surgery.

Why Mastectomy Surgery in India?

Of late, Mastectomy Surgery in India has become the most preferred option for women suffering from breast cancer. The Indian healthcare infrastructure has a wide network of world class hospitals, which are recognized at international level and maintain the highest quality of medical services and amenities making India the most preferred medical destination of the world.

The medical team performing the Mastectomy Surgery in India have well-qualified and world class doctors, consulting surgeons, nursing and caring staff which gives the best treatment. Most of the doctors have ample of experience in dealing cases regardless of the complexity both in India and abroad, whereas are qualified abroad from prestigious universities of developed nations in the west.

The hospitals are equipped with state-of-art technologies conforming to the modern medical centres of developed nations like US or UK clubbed with low cost budget. These are available at hospitals in the following cities with latest amenities and state-of-art-facilities.

What is the Cost of Mastectomy Surgery in India?

Mastectomy surgery in India is quite economical as compared to other countries of the world. India provides quality of the medical healthcare facilities at low price which makes India one of the best destinations for mastectomy surgery. One can have a fair idea of having the low cost medical treatments done in India and US.

Some of the common countries from which patients travel to India for surgery are:

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