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A bilateral mastectomy is a procedure to remove the breast tissue in both of the breasts. Removing the tissue in both breasts may be necessary because cancerous cells exist in both of the breasts or it may be useful as a preventive measure. When breast cancer is detected, the doctor and the patient may make the decision to undergo a mastectomy instead of other treatment methods. A mastectomy is recommended as the preferred treatment method in a number of different situations. Some of these situations include pregnant women in the first or second trimester of the pregnancy, widespread tumors which encompass the majority of the breast tissue, multiple tumors located in different parts of the breast, failed previous radiation treatments, a strong family history of breast cancer, a gene mutation which carries a risk of developing breast cancer again and even living too far away from the nearest radiation treatment center. Patients who fall into one or more of these categories and have evidence of cancer in each of the breasts may be candidates for a bilateral mastectomy.
Even in cases in which cancer is only affecting one of the breasts, a bilateral mastectomy may still be considered. This is called a risk-reducing or prophylactic procedure which means the second breast is being removed as a preventative measure. This is especially common in breast cancer patients who have a strong family history of breast cancer or who carry the gene mutation which puts them at high risk for developing breast cancer again in the future.
Interviewing plastic surgeons for a mastectomy procedure can be a difficult process. Finding the right plastic surgeon for any procedure can seem daunting because of the large number of well-qualified candidates and the fear of selecting a poorly-qualified candidate. However, when selecting plastic surgeons for a mastectomy, this complicated selection process may be made even more difficult if there is a sense of urgency and a need to select a surgeon quickly. Patients may start the selection process by asking the doctor handling the cancer treatment for recommendations for a mastectomy plastic surgeon. The patient may ask others who have gone through the process for recommendations.
One of the most obvious reasons a double mastectomy may be necessary is when cancer is affecting both of breasts. The doctor may recommend a bilateral mastectomy be performed to eliminate the cancerous cells. However, there are other treatment options available for one or both of the breasts if the cancer is not widely spread and if the patient is not at high risk for developing breast cancer again.
A double mastectomy is sometimes performed even when only one of the breasts is affected by cancer. In these cases, the decision to remove the tissue from both breasts as opposed to only the one containing cancer cells is largely preventative. Some patients may even have the preventative mastectomy in the absence of cancer. This may include patients who carry a gene mutation that makes them high risk for developing breast cancer or patients who have a strong family history of breast cancer and want to take measures to avoid developing breast cancer in the future.
Post-mastectomy treatments usually include periodic post-operative appointments with the surgeon to evaluate the recovery progress and the overall results of the procedure. If the mastectomy was performed as a treatment method for cancer, as opposed to a preventive measure, the post-mastectomy treatment regimen may also include a battery of tests to determine whether or not the mastectomy completely eliminated the cancer cells.
A breast reconstruction surgery may also be considered a post-mastectomy treatment option. Many patients who undergo a mastectomy also have a breast reconstruction procedure performed at the same time. This saves the patient the shock of having to see themselves after the breast tissue has been removed. However, it is not always possible for the patient to have the breast reconstruction immediately. This may be because of other health problems such as obesity, high blood pressure or diabetes. In these cases, the patient may have to rectify other health concerns before undergoing a breast reconstruction procedure. Patients may also not be eligible for immediate breast reconstruction surgery if the mastectomy did not remove all of the cancer cells. Finally, some patients may simply opt out of having breast reconstruction surgery performed immediately because they want to focus exclusively on the cancer treatments.
Treatment for lymphedema may be necessary after a mastectomy. The lymph nodes under the arm are often removed during a mastectomy. This may result in lymphedema or swelling of the arm. Treatment for lymphedema may include exercise, bandages, the use of an arm pump and diet.
Unlike cosmetic procedures, such as a breast augmentation, a mastectomy scar is typically long in length. A mastectomy will usually involve one long incision across the side of the breast to be removed. This allows the surgeon access to the breast to remove the necessary tissue and the lymph nodes under the arm, if necessary. With a bilateral mastectomy, the scarring will likely cover the entire length of the chest to allow for removal of breast tissue on both sides and the lymph nodes under each arm, if necessary.
A mastectomy is a procedure to remove most or all of the breast tissue from either one or both of the breasts. This type of surgical procedure is a common treatment for breast cancer patients in a variety of different situations. Situations where a mastectomy is the most viable treatment option for breast cancer include pregnancy in the first or second trimester where radiation treatment would be damaging to the baby, two or more tumors exist in separate locations in the breast, the size of the tumor encompasses most of the breast, previous radiation treatments were ineffective, there is a strong family history of breast cancer or the patient carries a gene mutation which makes the recurrence of breast cancer likely. However, despite the fact that many women undergo a mastectomy for a variety of reasons, dealing with life after a mastectomy procedure can be traumatic.
Women who undergo a breast reconstruction procedure with the mastectomy may find an easier transition back into life after the mastectomy. The breast is reconstructed during the process of the mastectomy, therefore when the patient wakes up from anesthesia, the breast has already been reconstructed. This means the patient never has the shock of seeing her body with one or both of the breasts missing.
However, women who are not eligible for an immediate breast reconstruction may find life after a mastectomy procedure to be troubling. This is because they will have to cope with the loss of the breast and may feel as though they are deformed. Additionally, the patient will have to either use clothing to mask the signs of the mastectomy or deal with the obvious signs that their breast is missing.
A mastectomy is a surgically-invasive medical procedure in which a substantial amount of breast tissue is removed. Additionally, the lymph nodes under the arm may also be taken out and some patients opt to have a breast reconstruction surgery with the mastectomy. For these reasons, patients should not expect recovery from a mastectomy procedure to be a simple process. In fact, mastectomy 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. These drains will be left in until the amount of fluid they are accumulating is minimal. Patients will likely only have to use the drains for one to two weeks after the surgery is completed.
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.
|Jennifer Mathes, Ph.D.|