In medicine, mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to combat breast cancer; in some cases, women believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer rather than treat it.
In contrast, in a wide local excision (also called a lumpectomy), a small volume of breast tissue containing the tumour and some surrounding healthy tissue is removed to conserve the breast.
Traditionally, in the case of breast cancer, the whole breast was removed. Often the mastectomy was performed during the same operation in which the biopsy was taken that confirmed the diagnosis. Nowadays the decision to do the mastectomy is usually based on the earlier performed biopsy. Also there is a trend to a more conservative approach to breast cancer. Practice has changed because of on the one hand improvements in radiotherapy and adjuvant treatment (e.g. chemotherapy or hormonal therapy) which mean a wider excision no longer makes local recurrence less likely and on the other hand a recognition that breast cancer metastasises early. Radical excision will not prevent later distant secondary tumours arising from micro-metastases prior to discovery, diagnosis and operation. In developed countries, only a minority of cancers is still treated by mastectomy.
Types
• Simple mastectomy (or "total mastectomy") illustration
• Modified radical mastectomy illustration
• Radical mastectomy (or "Halsted mastectomy") -- rarely done today illustration
• Skin-sparing mastectomy illustration
• Subcutaneous mastectomy PMID 11712794
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