Breast Cancer Surgery
Mastectomy
Definition
Mastectomy is the surgical removal of the breast tissue. There are 3 types of mastectomy:
- Simple mastectomy: removal of the breast tissue
- Skin Sparing Mastectomy: removal of the breast tissue including the nipple and areola complex with preservation of the skin envelop.
- Nipple Sparing Mastectomy: removal of the breast tissue with preservation of the skin envelop and the nipple and areola complex.
Please note that both Skin Sparing Mastectomy and Nipple Sparing Mastectomy procedures are usually associated with immediate breast reconstruction.
Wide Local Excision
Definition
Is usually refers to the surgical removal of a breast cancer with a safety surrounding margin of normal breast tissue. It’s usually performed for a palpable early breast cancer. It’s sometimes simply called “Lumpectomy”
Complications
As with any surgical procedure, a wide local excision may be associated with (not limited to) certain complications such as infection, seroma and a low likelihood of bleeding
There is also around 25-30% chance of further surgery depending on the final post-operative histopathology report.
Hook Wire Guided Wide Local Excision
Definition
An excision of a lesion within the breast along with some surrounding healthy tissue using a wire with a hook at its tip that is inserted into the breast to pin point the targeted area under image guidance. This procedure usually applies to a non-clinically detectable breast lesions.
Complications
As with any surgical procedure, a wide local excision may be associated with (not limited to) certain complications such as infection, seroma and a low likelihood of bleeding
There is also around 25-30% chance of further surgery depending on the final post-operative histopathology report.
Simple Mastectomy
Definition
Mastectomy is the removal of the breast tissue with the nipple and areola complex.
Complications
Simple Mastectomy is usually a safe procedure, however; it may involve some minor complications like (not limited to) infection and seroma (fluid collection under the wound. This is part of the natural healing process. If it happens, the fluid is reabsorbed by the body in most of the time. However; if the collection is sizeable then direct or image guided aspiration can be performed in the clinic).
Haemorrhage can occur in around 1% of the time and we might need to control this in theatre with a low possibility of blood transfusion.
Other complications can include (not limited to): scarring along the mastectomy wound, a possible mild limitation to shoulder joint movement both can respond to physiotherapy sessions and wound massage and numbness along the mastectomy scar.
Skin Sparing Mastectomy
Definition
Skin-sparing mastectomy involves the removal of the breast tissue including the nipple, yet preserving as much of the breast skin as possible. This procedure is usually associated with immediate breast reconstruction.
Complications
Just like the simple mastectomy.
Since this procedure is usually associated with an immediate breast reconstruction, there some complications which can be associated with the breast reconstruction part of the surgery, this can (not limited to) include:
- Insufficient blood supply to the skin envelop.
- Infection of the reconstructed breast tissue or to the breast implant which can potentially lead to loss of the breast implant.
Please note that your doctor will discuss all the above with you in more details.
Nipple Sparing Mastectomy
Definition
Removal of the breast tissue with preservation of the breast skin envelop and the nipple and areola complex.
Complications
As per the Simple Mastectomy and the Skin Sparing Mastectomy Complications.
In addition to the above, with the Nipple Sparing Mastectomy there is a small chance of compromising the blood supply to the nipple and areola after the surgery.
Please note that your doctor will discuss with you all the above (and potential others) in more details at the time of your consultation.
