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How familiar are you with types of mastectomy? For example, can you differentiate between a simple and a modified radical mastectomy? If your client/patient has had a radical mastectomy, do you know which muscles will be affected?
The type of mastectomy the health care provider recommends for your client will depend on the tumor's size and location, the extent of invasion of adjacent tissue, and whether the regional lymph nodes are affected. The chart on this page will give you specific information on different mastectomy types.
EXTENDED RADICAL
REASON FOR SURGERY
Large or invasive tumor.
Lymph node involvement.
SURGICAL PROCEDURES
Removes the entire breast, major and minor pectoral muscles, axillary and internal mammary lymph nodes (possibly with rib cage excision), and fat.
CONSIDERATIONS
Client left with hollow area beneath clavicle.
Lung may be injured during surgery.
Client may develop post-operative complications, such as infection and atelectasis.
Client may need as long as 1 year to recover fully; she must exercise regularly to strengthen remaining arm and chest muscles.
Client may lose some feeling in affected arm and shoulder from cut nerves.
HALSTED RADICAL
REASON FOR SURGERY
Large or invasive tumor.
Lymph node involvement.
SURGICAL PROCEDURES
Removes the entire breast, major and minor pectoral muscles, axillary and internal mammary lymph nodes and fat.
CONSIDERATIONS
Client may develop lymphedema and shoulder stiffness.
Client may develop post-operative complications, such as infection and atelectasis.
Client may need as long as 1 year to recover fully; she must exercise regularly to strengthen remaining arm and chest muscles.
MODIFIED RADICAL
REASON FOR SURGERY
Large cancerous tumor.
Lymph node involvement.
SURGICAL PROCEDURES
Removes the entire breast, some fat, and most of axillary nodes; chest muscles remain in place.
CONSIDERATIONS
Gives client a more cosmetically pleasing appearance than other radical mastectomies.
Reduces risk of lymphedema development.
Unlike other radical mastectomies, does not severely weaken affected arm.
TOTAL OR SIMPLE MASTECTOMY
REASON FOR SURGERY
Large tumor; without muscle or lymph node involvement.
SURGICAL PROCEDURES
Removes the entire breast and some fat tissue but leaves muscle and axillary lymph nodes in place.
CONSIDERATIONS
Client recovers rapidly and experiences no edema, because her lymph nodes are intact.
Leaves smaller scar than radical mastectomies.
Causes no loss of muscle power.
PARTIAL OR SEGMENTED MASTECTOMY
REASON FOR SURGERY
Small, self-contained tumor near nipple.
SURGICAL PROCEDURES
Removes breast tissue wedge (2 to 3 cm of tissue surrounding tumor), fascia, tumor, and skin.
CONSIDERATIONS
Although breast is partially saved, it's markedly disfigured. Reconstruction, however, can return the client's breast to acceptable structure.
LOCAL WIDE EXCISION
(Tylectomy or Lumpectomy)
REASON FOR SURGERY
Very small, self-contained cancerous or precancerous tumor; fibroid tumor that doesn't respond to conservative treatment.
SURGICAL PROCEDURES
Removes tumor and small amount of surrounding breast tissue; leaves muscles, most skin, and lymph nodes in place.
CONSIDERATIONS
Can be done in a health care provider's office or clinic, in the hospital on an outpatient basis.
Client is still capable of breastfeeding.
If a tumor is cancerous, procedure is usually combined with other treatments, such as chemotherapy or radiation therapy.
SUBCUTANEOUS
REASON FOR SURGERY
Multiple, persistent non-cancerous breast nodules.
Family history of breast cancer in patient who has progressive breast nodularity.
Nodularity or cystic disease in one breast when cancer has been found in the other.
SURGICAL PROCEDURES
Removes internal breast tissue; leaves skin and possibly nipple.
CONSIDERATIONS
Usually considered only after more conservative therapy has failed.
Reconstruction returns breast contour to normal, especially if nipple is saved.
MOONDRAGON'S BREAST CANCER LINKS
Learning About Breast Cancer
Learning About Breast Surgery
Understanding Breast Tumor Staging
Familiarizing Yourself With Diagnostic Techniques
Understanding Fibrocystic Breast Disease
Guide To Types of Mastectomies
Patient Preparation For A Mastectomy
Mastectomy Care After Surgery
Learning About Breast Reconstruction
Selecting A Prosthesis
Applying An Arm Sleeve and Gauntlet
Preventing Complications After A Mastectomy
MoonDragon's Obgyn Information: Breast Cancer
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