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From breast cancer to prevention: Who should consider mastectomy?
Mastectomy refers to the partial or complete removal of one or both breasts. It is usually used to treat breast cancer. However, some women considered to be at high risk may choose this surgery as a preventive measure. The choice of surgery for breast cancer is not only related to the patient's health, but also affects psychological and social aspects. This article discusses the indications, procedures, postoperative outcomes, and factors that should be considered in decision-making for mastectomy.
The purpose of mastectomy is not limited to treatment but also prevention, especially for high-risk patients with BRCA gene mutations.
Indications for mastectomy
Although more and more breast-conserving treatment techniques are available for breast cancer patients, some patients may still be better suited to traditional mastectomy. Scenarios to consider include:
- Patients who have received radiation therapy to that side of the breast.
- Two or more cancer lesions in the same breast that are too far apart to be removed through a single incision.
- Patients in whom initial breast tumor resection (including one or more revision resections) did not completely remove the cancer.
- People with certain serious connective tissue diseases, such as scleroderma, are particularly sensitive to radiation therapy.
- Pregnant women who need radiation therapy.
- Patients with tumors larger than 5 cm in diameter and poor response to neoadjuvant chemotherapy.
- Patients with BRCA1 or BRCA2 gene mutations who choose prophylactic mastectomy.
Possible side effects after surgery
In addition to postoperative pain and obvious changes in breast shape, mastectomy may cause other side effects, such as:
- Pain, scar tissue, and short-term swelling in the surgical area.
- Phantom limb pain (pain in the removed breast or tissue).
- Wound infection or bleeding, hematoma and seroma.
- Problems such as lymphedema, especially if lymph nodes have also been removed.
- Upper extremity problems, such as pain, weakness, and limited movement in the shoulders and arms.
Preparation before surgery
A preoperative meeting with your physician is critical to discuss the risks and benefits of surgery. Patients need to know whether breast reconstruction surgery will be performed and the timing of reconstruction. Paying attention to healthy habits such as diet and reducing smoking and alcohol intake before surgery can help speed up postoperative recovery. In addition, patients should inform their doctors about the medications, vitamins, and supplements they take to avoid complications during surgery.
Postoperative care and recovery
Patients undergoing mastectomies are often given a prescription for pain medication before leaving the hospital to relieve discomfort at the surgical site. You should watch for signs of infection after surgery and avoid heavy lifting or strenuous exercise during the healing period. Generally speaking, patients can return to work and daily activities after 4 weeks.
Contemporary trends
More women are choosing to undergo mastectomies, even in some cases where surgery is not required, according to research, sparking concern among the medical community. Taking the United States as an example, the proportion of mastectomies has increased over the past few years, and the proportion of bilateral mastectomies in particular has increased significantly.
Whether used as treatment or prevention, mastectomy can have a profound impact on a patient's life.
Conclusion
The decision-making process for mastectomy is complex and involves many considerations. Patients should fully understand their situation and discuss the most suitable option with the medical team. With the advancement of medical technology, how to balance treatment needs and quality of life considerations is a question that every patient needs to think deeply about.
