What is breast removal called? Breast removal postoperative period

She told BeautyHack why she voluntarily decided to have a mastectomy, and explained where to go and what tests to take if you have a high probability of malignant tumors.

How it all began

I am now 25 years old, and in February I decided to have surgery to remove my mammary glands and replace them with implants. But this story began much earlier. 3.5 years ago my mother fell ill with ovarian cancer. Before this, my grandmother was diagnosed with breast cancer. Almost all relatives on my mother's side had this disease.

After my mother got sick, I was told to get tested for tumor markers every six months. But for people like me, this is not really an option. Because the result of the analysis is influenced by many factors: physical state at a specific moment, overwork, etc. I understood that I needed to solve the problem differently.

A year and a half ago, I started thinking about breast reduction. I was a size D, and it started to bother me: my neck hurt, I slouched and couldn’t pick up my underwear. In the fall of 2017, I first met with the doctor recommended by my mother, Sergei Nikolaevich Voronov from the Plastic Surgery Center of the Russian Railways Departmental Hospital in Ivanovo.

I was sure that I would persuade him to have the operation. She arrived, told me about her mother (she passed away a year ago), the doctor examined the breasts and noted that there was already ptosis (that is, stretching of the tissue), and he was not against reduction. Sergei Nikolaevich also clarified when I last time I checked my breasts, that is, I did an ultrasound and was at an appointment with a mammologist, but this is exactly what I never did: I thought that this was something that needed to be done after 35 years. Although I always had annual medical examinations.

Then the doctor described the examination scheme before the operation: consultation with a mammologist, ultrasound, x-ray, blood test for BRCA gene mutations - this is what reveals a predisposition to cancer. There are several types of analysis, but BRCA1 shows the likelihood of breast and ovarian cancer. Sergei Nikolaevich explained that if mutations are detected, then it makes sense to immediately do preventive mastectomy with one-stage reconstruction. I knew about this operation and even understood that I might have it done in the future, but I didn’t expect it to happen so early.

Difficulties arose already at the stage of going to the radiologist. As a rule, X-rays in such situations are not done until the age of 35, considering this an unnecessary measure, but I was able to come to an agreement. An ultrasound found a mass in the right breast and advised me to return in a month - for now it was harmless.

Then I explained to the mammologist that I had come to him from the surgeon and was preparing for surgery. He said that there was no need for her now and sent her for a consultation to the Herzen Oncological Institute in Moscow. They also explained that the formation should be monitored; it is unlikely to be malignant, but an x-ray can be taken in a month. When I told about my situation, I received a lot of negative comments in the style of “you’re still young, you don’t have children, why cut out a healthy organ.” At that time, I already had BRCA test results: 85-90% chance of developing breast cancer, 45% - ovarian cancer and 15% - bowel cancer. Knowing the unpredictability of this disease from my mother’s experience, I had already made my decision, deciding not to play with fire. I understand that breastfeeding a child is important, but it is much more important to have a healthy mother next to him.

With this attitude, I returned to the Plastic Surgery Center in Ivanovo, where, after a long consultation of three doctors (in addition to Sergei Nikolaevich, there was surgeon Natalya Sergeevna Voronova and mammologist-surgeon Maxim Valeryevich Venediktov), ​​it was decided to do a mastectomy while preserving my nipples. They called me two weeks later and scheduled the day for the surgery.

Separately, I will say that there are no quotas for carrying out just such an operation in our country; it is paid. Yes, women undergo a standard mastectomy if they have tumors, but this is the kind of operation that few doctors undertake. After all, before that I was in one of the largest oncology centers in Moscow, and with a 90% probability of breast cancer, the doctor did not even consider this option. This is why I strongly advise people to get a BRCA blood test - it is very accessible, but for some reason not everyone is told about it.

Operation

Two weeks before the operation, I began to panic, because I only theoretically understood what awaited me. I found a couple of photos online of women who did something similar and talked about it in in social networks. There is a lot of information on the topic of cancer, but here there is nothing, both in Russian and in English.

The operation lasted just over four hours. Mastectomy was performed under general anesthesia, I woke up only the next day and took a very long time to recover. I seemed to be conscious, but I don’t remember many things.

After the operation, I spent a week in the hospital under the supervision of doctors. Severe pain there was none during rehabilitation. I know that girls who have breast enlargement complain of pain, but this is not the case: in the hospital they injected me with painkillers 5-6 times a day, and I slept almost all the time, did not move, I could not even wash my hair myself - I did this my boyfriend. By the way, he was immediately in favor of removing the mammary glands and throughout the entire journey he helped me a lot, like all my relatives - what a support group!

Rehabilitation

Already in the hospital a problem arose: the left nipple was recovering well, but the right one remained dark. However, I was discharged home, and then the most unpredictable thing happened: I started to panic! The hospital in Ivanovo is located 400 km from home, I am far away, despite the fact that I am in constant contact with the doctor, an allergy has appeared on my body (it turned out that it is an allergy to Levomekol, which needs to be smeared on the nipples), and in my head the thoughts “What if Am I having a reaction?”

I was afraid to move, did not use ointment, everything began to heal, but the problem with the right nipple remained, it became darker.

Three weeks after the operation, I came for the first examination, and the doctors said that the right nipple had not healed. It was removed immediately, the operation took no more than five minutes. Then, of course, I was in shock, and it was not so much the absence of a nipple that scared me, but the presence of an open wound. The doctor explained that it needs to be treated three times a day to prevent infection.

At home, I had no idea how to make a bandage, but in the end I pulled myself together, took off the bandage, stood in front of the mirror and gave myself time to get used to it. Once a week I visited the doctor (he examined the wound) and at the same time studied options for nipple restoration. The first is to make it out of skin (the darker scar tissue on the wound has already given the areola effect). The second is to make a prosthesis. It is waterproof, attached with special glue and lasts for three months. First, I decided to wait for a full recovery and then make a decision.

Now, three months after the operation, I have almost recovered. And in this regard, the question arose: is it necessary to do anything at all? From an aesthetic point of view, the areola looks natural. But if I decide to have it restored, both nipples, my own and the restored one, will look different. So I gave myself a summer to think about it, to see how comfortable I was in this state.

In general, rehabilitation would have been faster if not for this problem. After one and a half to two months everything looked good. Now there is only slight redness in the area of ​​the stitches and swelling, but this is also normal.

How to live after surgery

For three months after the operation, doctors do not allow you to remove your bra at all (but not with underwires - they put pressure on the stitches). I save myself with sports ones because they are lighter. Two months later, I started doing yoga without putting much strain on my arms.

Implants come with a lifetime warranty. If previously they were silicone and could really burst, now they are made of biomaterial (even if something happens to the implant, the liquid in it will not harm the body).

Now my breast size is C. That is, in fact, it has decreased by only one size. But outwardly the difference is very big. She became more toned due to the anatomical, rather than round, implant. I think that over time it will be even less.

There are no restrictions after the operation. After recovery, you can, for example, plan a pregnancy. This is one of the differences between a mastectomy and breast reduction surgery, when you have to wait a year and a half so that the shape does not become deformed during pregnancy.

As for the likelihood of cancer, you will have to monitor the situation in any case. There is no need to exclude ovarian and intestinal cancer, a predisposition to which was revealed by the analysis. I have already said that tumor markers are not the most informative thing (the results can help if there are additional tests). Therefore, I will regularly do ultrasounds. I don’t exclude the possibility that in the future it will be necessary to remove the ovaries, but for now I prefer not to think about it - after all, this is a more age-related disease, unlike breast cancer.

The only side effect after the operation is depression. I had light form depression immediately after discharge. In life, I am not an alarmist, I can pull myself together, I make balanced decisions, but in the first weeks after the operation there were breakdowns and tears. From this situation I drew one conclusion: the main thing is to control yourself! Because now I know for sure that I made the right decision. I am not advocating surgery, but people should be aware of this possibility. When you already have a malignant tumor, surgery and recovery are much more difficult.

Besides, I want to believe that my story will help someone or even save a life. People are already asking what tests I took and where. The next good thing is my collaboration with Anna Pisman's jewelry brand Moonka Studio. This summer we will be making a collection of jewelry, a portion of the sales from which will go to the Cancer Foundation!

Similar materials from the category

Mastectomy is a surgical operation associated with the removal (complete or sometimes partial) of the mammary gland.

The very essence of this operation terrifies most women, and the idea that breast restoration after a mastectomy requires significant effort is also unlikely to add optimism to anyone.

However, often this operation is almost the only correct solution to protect women from more big problems with health.

Note that the essence of the operation, which is usually called a mastectomy, is:

• Removal (complete or partial) of breast tissue from women (or rarely men).
• Removal (complete or partial) of existing fatty tissue, which usually contains those The lymph nodes, which may be probable metastatic sites.
• Removal (complete or partial) of both the pectoralis minor and major muscles of women, but this usually depends on the chosen option for the mastectomy itself.

Naturally, the postoperative period after such surgical correction, the full recovery of women can be quite long and difficult, not only physically, but also purely psychologically.

And all because most women after such an operation may experience significant pain, both physical and mental.

When does it become necessary to remove the mammary gland?

Quite often, a mastectomy may be required after detection in women (less often men):

• Cancerous tumors in the mammary gland.
• After confirming the diagnoses of nodular mastopathy, breast sarcoma.
• Or after the development in women of some forms of purulent inflammation (mastitis) of the mammary gland.

It is extremely rare, but still mastectomy can be used for preventive purposes in women, if proven by research, genetic predisposition specific patient to the development of breast cancer problems.

Also, this operation can be performed purely for cosmetic purposes in men suffering from gynecomastia.

It should be noted that, as a rule, none of the women who are faced with the need for such an operation can cope with just removal of the mammary gland.

Today, most patients require a number of surgical actions that allow not only to remove the mammary gland affected by the disease, but also to then carry out its full restoration.

Plastic surgery (after breast removal), which is the restoration of the operated mammary gland, is today one of the most complex, but at the same time, the most popular.

Currently, after radical mastectomy (or its other variants), so-called reconstructive surgeries are used as widely as possible. These are operations that are performed using the patient’s own tissue.

Of course, no less popular after removal of the mammary gland is the so-called mammoplasty, using special endoprostheses, which is used in cases where the patient herself does not have a sufficient amount of free tissue.

In general, we note that the recovery of patients undergoing mastectomy is a process, although long and complex, nevertheless, quite familiar to modern doctors, and even well-established.

This means that no matter how difficult and lengthy rehabilitation may seem to a woman, it is always a period that passes and is quickly forgotten.

Possible complications during breast removal

Unfortunately, some patients who are faced with the need to undergo surgery to remove the mammary gland may also encounter some complications of this treatment, both during the rehabilitation period and after it.

Naturally, these may be complications of the of different nature. For example, immediate complications of breast removal may include:

• Varying degrees of severity of bleeding, which most often occur in the earliest postoperative time period.
• Dangerous suppuration of the postoperative wound site.
• The so-called profuse lymphorrhea, etc.

Sometimes patients may encounter so-called long-term complications of breast removal surgery. As a rule, these can be:

• Conditions of lymphostasis, when the patient suffers from a violation of the full outflow of normal lymph fluid, which, accordingly, is accompanied by lymphatic edema of the arm from the side of the removed mammary gland.
• Some mobility impairments directly in shoulder joint, again, from the side of the removed mammary gland.

No less often, patients encounter various kinds of psycho-sexual complications. Among such complications are usually called: postoperative depression, a feeling of one’s own inferiority or inferiority.

Sometimes such women independently limit social contacts, and as a result, begin to experience some difficulties in sexual life, which is completely unacceptable while maintaining normal sexual function.

And of course, it should be noted that most women who have undergone such a procedure remember the rehabilitation period as a time when they experience certain pain. In this case, the degree of pain during breast removal can vary from moderate to severe manifestations.

How to get rid of pain after breast removal?

First of all, I would like to say that the rehabilitation process of patients with a removed mammary gland must be controlled.

It is strictly unacceptable to remain without medical support and assistance during the recovery period; doctors will be able to promptly prescribe painkillers for severe pain and adjust the necessary treatment.

Often, such patients may be prescribed anti-inflammatory non-steroidal medications, as well as ointments or balms, for local effects on the operated breast.

Sometimes in the postoperative period, patients require antibiotics, immunostimulants and even antidepressants. This means that no matter how bad you feel, consciously refuse medical help in in this case simply unacceptable.

The recovery process will be easier and faster if the patient actively helps the doctors in this, accurately following all instructions, and of course, having a positive attitude towards the existing problems.

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Mastectomy - postoperative period

A mastectomy is a surgical procedure to remove the breast. Reasons for having a mastectomy: cancer tumor breast, breast sarcoma or purulent formations.

A radical mastectomy involves removing the entire breast. Subcutaneous mastectomy involves preserving tissue reserves; the area of ​​the nipple and areola remains untouched. Removal of the mammary gland is already a radical operation that causes maximum changes in the postoperative period.

Rehabilitation after subcutaneous mastectomy is much easier than with radical surgery. Recovery after a mastectomy should begin immediately after surgical intervention.

Gymnastics after mastectomy

Therapeutic gymnastics after a mastectomy should be carried out in the presence of an instructor, and over time the woman can do it on her own. If the function of the shoulder joint deteriorates, it is necessary to use rocking movements, raising and abducting the arm. The affected arm should be gradually involved in everyday movements: combing hair, drying with a towel, etc. A gymnastic stick will be useful for treatment. The goal of gymnastics should be aimed at restoring arm mobility and improving the woman’s well-being.

It is very important to do gymnastics regularly and gradually increase the load without sudden movements. When exercising after a mastectomy, it is not recommended to overdo it.

Complications after mastectomy

Complications after mastectomy may be largely associated with antitumor treatment tactics. Common complications after mastectomy:

• blood clotting disorder;
• phantom pain;
• bleeding;
• lymph outflow;
• deterioration of the shoulder joint;
• rachiocampsis;
• neck pain;
• slow healing of the wound area;
• scar formation;
• depressive states, etc.

Breast reconstruction after mastectomy is common. The breast can be reconstructed both during and after surgery. Most women choose not to have breast reconstruction or implants because there are a number of risks. Most often, women agree to use exoprostheses.

Nutrition after mastectomy plays a role important role. The diet must be changed, it is necessary to give up fatty and refined foods and pay attention to vitamins.

Women need to understand that life does not end after a mastectomy. Thanks to modern innovative technologies in the treatment and diagnosis of cancer, thousands of women remain healthy and return to full life. It should be noted that the need for a mastectomy can occur in both women and men.

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Mastectomy is a life-saving operation. Postoperative rehabilitation

Postoperative rehabilitation after mastectomy

When the operation is over and there are no complications on the first day, the woman is transferred to the intensive care unit and literally the next day she must get up and begin a course of important postoperative rehabilitation measures. You should not feel sorry for yourself and become despondent - this will greatly lengthen the recovery period. At this time, a woman should have special primary underwear after a mastectomy, designed to secure a temporary textile exoprosthesis. This helps the wound heal faster and prevents injury to a fresh scar.

Usually, the mastectomy itself and the first days after the operation pass without complications and the woman is sent home after 2-3 days, with drainage tubes in her chest. Medical personnel will be trained in how to maintain the drainage. After subcutaneous mastectomy with breast reconstruction, hospitalization lasts longer - up to 5-6 days.

The first few days after breast removal are the most difficult and painful. You have to take painkillers, but only those prescribed by the doctor. After the 3rd day, the pain gradually goes away. You should get up after surgery calmly - do not make sudden movements, do not raise your arms above your head, and do not lift anything heavy.

You will need to regularly undergo dressings and aspiration of the seroma that forms under the skin after removal of the drainage tubes - about 3-4 weeks. If fluid accumulates and does not resolve, it must be removed using a needle aspiration. During this period, based on the results of tests, biopsies and examinations, a further course of treatment is prescribed - chemotherapy, hormonal therapy, radiation therapy or combination treatment. By the way, this complex therapy can only be performed with the patient’s consent. No one will force a woman to take chemotherapy or radiation. Full physical recovery after mastectomy, in the absence of complications, is possible after one and a half to two months.

Now we will outline point by point the most important difficulties that await a woman after mastectomy surgery, during therapy, and after completion of the course of treatment.

1) Oddly enough, the most important problem for most women is not physical, but psychological - many experience a period of depression. This greatly complicates the healing process itself, increases fatigue, and reduces the body’s defenses. It is extremely important to prevent a woman from becoming indifferent to her fate at this time and to support her. The support of relatives is especially important. It also helps to communicate with women who previously had a mastectomy, returned to a full life and are now helping others cope with this problem. For many women, the experiences they have endured result in aggression towards the world and their families, but this is natural. Any outburst of feelings, even negative ones, indicates that the woman is actively fighting for life and over time her condition will stabilize. It is much worse when the patient withdraws into herself and becomes indifferent to everything. In this case, you definitely need to communicate with a professional psychologist or psychotherapist. For a period of psychological adaptation It takes from 3 to 6-7 months to reach a new state.

2) It is imperative to allocate funds from the family budget for a high-quality exoprosthesis, buy underwear after a mastectomy, and everything so that the woman can compensate for the deficit in breast volume as comfortably as possible.

3) A woman must independently learn to care for a postoperative scar, take care of herself - for 3 years do not lift weights exceeding 1 kg, do not do difficult homework, especially in an inclined position - to wash, wash floors, care for the garden, etc. It is especially important to adhere to this recommendation for women with lymphedema, that is, stagnation of lymph (lymphostasis) in the arm on the operated side.

4) Regarding work in the garden and vegetable garden, you should approach it very carefully and only do it with gloves. The reason for this is that due to the obstructed flow of lymph, the body cannot quickly and adequately respond to ingestion. pathogenic microbes into the smallest scratch or abrasion. And this, in turn, can provoke such an unpleasant disease as erysipelas. In general, in case of the slightest injury, you must immediately treat the wound antiseptic solution, at least with iodine or brilliant green.

5) We talked about the nutrition system after a mastectomy in a separate section - the rules are simple, everyone knows them anyway, but few people adhere to them before illness: do not overeat, bring your weight back to normal, eat nutritious, healthy, fresh food. We must give up smoked meats, pickles, and canned foods. Limit sweets as much as possible. But this doesn’t mean that sometimes you can’t eat a piece of something tasty for pleasure. And of course – don’t drink, don’t smoke.

6) Other restrictions include baths and saunas. And it’s better to replace a bubble bath with a shower. But you can engage in swimming and physical exercise some time after the wound has completely healed. A common question is whether it is possible to go to the sea and sunbathe. In fact, in the first years after treatment it is not recommended to change the climate zone, so as not to provoke the return of the disease. But, in principle, you can go to the sea, you just can’t be in the open sun and relax in the shade. Be sure to purchase special underwear for exoprosthetics, as well as a special swimsuit for women with a silicone prosthesis, which can be either open or closed.

7) After undergoing oncology and mastectomy, it is categorically not recommended to become pregnant - this is due to a sharp hormonal change in female body, which can become a provoking factor for the return of the disease.

8) In the first year after a mastectomy, you should visit your doctor at least once every three months, and in the next 5 years - every six months. Further visits to the doctor - once a year. At the same time, an oncologist must be constantly consulted if a woman receives any prescriptions from another specialist for the treatment of any disease - pharmaceuticals, physiotherapeutic procedures, a course of immunomodulators, etc.

9) Regarding release from work. After a mastectomy operation, a sick leave certificate is issued for a period of 10 days after the stitches are removed, if there are no complications, but with the possibility of extending it for another 30 days. If appointed further treatment– sick leave is issued for the duration of treatment, but not more than 120 days. After this, the woman must undergo a VTEK commission, which will decide to extend the sick leave or transfer the woman to the disability group.

10) The prognosis after mastectomy is favorable. Especially if the disease was identified in the early stages and adequate treatment was provided. The 5-year survival rate for stage 1 cancer is more than 97%, for stage 2 cancer it is about 80-85%. It also depends on the type of malignant tumor. Metastases occur in 8-9% of patients in the first 5 years. The same number of women have so-called latent (hidden or dormant) metastases, which can appear 10 or a year after the initial diagnosis and mastectomy. Metastasis occurs along the bloodstream - hematogenous metastases occur in the lungs, bones, kidneys, and liver. If malignant cells spread through the lymphatic flow, then metastases are possible in all lymph nodes.

Anyway, surgical removal breast tumors and a subsequent course of anticancer therapy allow a woman to maintain a full life for long term. Without treatment, breast cancer develops quickly and is fatal. The diagnosis of breast cancer today is the most positive regarding survival. Especially when a woman is determined to fight the disease and return to a full life. Help cope with medical problem Doctors will help you, relatives and psychologists will help you with psychological experiences, and to make life more comfortable - high-quality breast exoprostheses and underwear after mastectomy, which can be ordered on our website or purchased in the Valea store chain.

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Recovery after a mastectomy

Mastectomy is surgery for partial or complete removal of breast tissue affected by cancer. The patient needs a long period recovery after such an intervention. It usually lasts about two months for physical recovery and six months for psychological recovery.

Postoperative rehabilitation

If no complications arise within a day after the mastectomy, the patient is placed in the intensive care unit. You can and should get up the day after the operation. How formerly a woman begins to carry out rehabilitation measures, the lower the risk of developing complications such as lymphostasis, erysipelas, and recovery will be faster. If rehabilitation is started late, then this process will take longer and be more painful.

Those who have undergone surgery almost immediately experience intense pain in the chest area. To reduce them, the attending physician must prescribe painkillers. It is recommended to use them in moderation, preferably only for acute pain. Before this, an anamnesis is compiled with information about allergies and reactions to medications. Alcohol consumption and driving are prohibited during this time. vehicle. Pain in the larynx may be present after general anesthesia.

At first, there may also be a fever and a slight increase in body temperature, but such a reaction should not cause concern; this is quite normal during surgery, unless, of course, the negative symptoms intensify and serious side effects such as erysipelas, lymphostasis, etc. .d.

Temporary side effects during breast removal are swelling and hematomas; to eliminate them, it is recommended to use heating pads with ice in the armpits and lymph node dissection areas. The incisions are sewn up with a special material and covered with sterile bandages, so it is prohibited to correct or remove them yourself. The bandage is removed after a week, and the stitches after two weeks, if they have not dissolved by then.

The woman is given a special drainage to drain excess fluid; it is made of a plastic tube inserted subcutaneously on one side and a bag for receiving it on the other. A day after the drainage is removed, the patient is allowed to take a shower. You need to be careful when wiping the suture area; they should be gently blotted with a towel, avoiding moving the sterile dressings.

Often patients are concerned about the question of how many days they need to stay in the clinic after a mastectomy. As a rule, the operation and several days after it proceed without complications, and on the third day the patient is discharged from the hospital home without removing the drainage tubes. Health care providers should be trained in how to properly handle the drainage system. In the case of subcutaneous mastectomy with breast reconstruction, the period of hospital stay is increased to six days, in order to avoid implant rejection and the development of erysipelas.

The pain begins to subside after the third day. The woman should get out of bed calmly, without sudden movements, avoid carrying heavy objects and not raise her arms above her head. You will need to visit the clinic for about four weeks, do dressings and remove the serous fluid that forms after removing the drainage under the skin. Next, based on the testimony of tests and examinations, the doctor prescribes subsequent treatment. It could be:

• chemotherapy;
• hormonal therapy;
• irradiation;
• combined treatment.

All procedures are carried out only with the consent of the patient; no one can force you to take chemotherapy or undergo radiation. Return to the previous way of life occurs after about two months, if no complications arise.

Postoperative complications are determined by the volume of surgical intervention and are post-traumatic. The most typical are shifts in blood clotting parameters, erysipelas, and lymphostasis. Phantom pain and asthenia are also characteristic. Since the patient has postoperative stress, wound healing may worsen and the period of lymphorrhea and scar formation may increase.

When diagnosing, the doctor relies on the patient’s complaints, the nature of the pain and test results, as well as his own examination. The table below shows rehabilitation measures for various complications.

Table 1 - Complications and rehabilitation measures after mastectomy

• exoprosthetics;
• care recommendations;
• selection of special underwear.

• pneumomassage, lymphatic drainage;
• use of bandages;
• photodynamic therapy;
• physiotherapy;
• hydrokinesitherapy;
• metabolic therapy;
• therapeutic nutrition.

• physiotherapy;
• hydrokinesitherapy;
• wearing bandages to correct posture.

So, let’s outline the difficulties that patients face after undergoing surgery to remove the mammary gland, as well as during and after treatment:

• The most common problem is depression, which makes the entire recovery process from cancer difficult. It aggravates the patient's condition, increasing fatigue and reducing the body's defenses. We need the support of family and communication with those who have already undergone these procedures and returned to a full life. In severe cases, it is recommended to contact psychotherapists so as not to delay the period of psychological adaptation.
• After a mastectomy, it is imperative to purchase a good exoprosthesis and choose the right underwear so that the woman does not have complexes due to the lack of a mammary gland.
• The patient needs to learn how to independently care for the scar to avoid inflammation. Be careful with lifting weights; for three years you should not lift anything weighing more than 1 kilogram. Limit housework, especially if it involves an inclined position. This is very important if there is stagnation of lymph in the arm from the side of the operation.
• Be careful when working in the garden, do everything in seals to avoid introducing germs into small wounds. Due to the deterioration of lymph outflow, there is a threat of erysipelas. All cuts and scratches should be treated with antiseptics!
• When breast cancer is removed, it is not recommended to become pregnant, as a hormonal surge can trigger a recurrence of the disease. Proper nutrition plays a big role in recovery. The diet is simple and effective. It is better to exclude smoked and canned foods completely. It is recommended to limit sweets during this diet. In the diet, as much as possible, you need to increase the amount of vitamins and reduce fats. Naturally, you cannot smoke or drink alcohol. Main principles:
  • don't overeat
  • maintain normal weight,
  • eat fresh and healthy food.
• Special exercises also help with recovery. They must be done while still in the hospital. Developing the arm with the help of gymnastics and massage to prevent lymphedema should begin as early as possible, gradually increasing the load. You need to be careful with this and do the exercises regularly. Monitoring your posture is also important because the load on the spine changes.
• Swimming and physical exercise have a beneficial effect on the healing body. And it is more rational to replace taking a bath with shower procedures. It is useful to swim in the sea, but it is forbidden to be in the sun. It is also important to know that changing climate zones is unfavorable, as it can provoke a recurrence of breast cancer.
• Constant observation by a doctor during the first year once every 3 months, in the next five years - once every six months. It is necessary to consult with an oncologist when prescribing treatment by other doctors, be it immunotherapy or physiotherapy.
• Partial release from work or disability. Immediately after the operation, a ten-day sick leave is issued, with an extension, if necessary, for another month. If complications occur, then it is issued for the entire period of treatment. But this period of time should not exceed 4 months. Some time after the mastectomy, the woman undergoes a medical commission, which makes a conclusion on the need to prolong the sick leave, or an ITU, which assigns the patient a disability group. The mere fact of breast removal is not a reason for disability in the Russian Federation. It can be given temporarily to continue treatment, or permanently in case of threat of metastases. In any case, the issue of granting a disability group is decided by a medical and social examination, which is referred by the attending physician.

In general, the prognosis after mastectomy is quite favorable, especially in cases early detection and proper treatment of breast cancer. The survival rate for the first stage of the disease is slightly less than 100%, for the second - up to 80%. The type of malignancy of the neoplasm also influences this. The appearance of serious complications (erysipelas, lymphostasis) causes more negative prognoses.

Timely removal of the tumor and a course of subsequent therapy can save the patient’s normal life for a long time. Without treatment, this disease progresses extremely quickly and leads to disability and death. Breast cancer today has one of the most positive prognosis for survival. It is important to remember that life goes on after a mastectomy. A woman should tune in to a good outcome, this is very helpful in the fight against the disease.

Breast removal postoperative period

Despite the confusion and depression after breast removal surgery, a woman must first of all understand that she needs to start the next chapter in life, let her body get used to the changes, it is especially important to try to avoid lymphatic edema or osteochondrosis. Simple exercises that should be performed immediately after surgery will help with this.

Therapeutic exercises are recommended to restore arm mobility, correct posture and normalize general well-being. For rehabilitation of hand function, exercises in the pool are also effective. When receiving treatment, the patient should be aware of possible complications and prevention methods that can help avoid this.

What to do in the early postoperative period

First of all, you need to understand that after breast removal surgery, everything preventive actions needs to be done comprehensively. So!

• Do special exercises every day. Certain physical exercise improve muscle tone, lymph and blood flow, joint mobility. They also reduce the likelihood of developing edema and inflammation.
• To strengthen blood vessels, you need to take vitamins (as prescribed by your doctor).
• Take care of your skin. It is necessary to regularly lubricate the skin of the hand on the side of the operation with special cosmetics - preferably plant-based.
• Watch your hand. It is a good idea to write down signs of swelling, especially if it changes quickly.

• Buy a special elastic sleeve at the pharmacy.
• Do not load your sore arm with muscle work.
• Do not allow your arm to remain in a state of extension or flexion for a long time.
• Get a massage regularly. It is especially effective in the early postoperative period.
• Protect your hand from injuries, wounds, abrasions, bruises, and insect bites. Since all this can become an additional source of infection, which can intensify pathological processes in the area of ​​edema.
• Never measure blood pressure on the breast surgery side of the arm. You also cannot give injections or take blood tests.

• The hand must be protected from direct sunlight.
• Do not put your arm under pressure, that is, do not wear clothes with narrow and tight cuffs. The same applies to jewelry (rings, bracelets, watches, etc.).
• When washing dishes and taking a bath, do not use too much hot water. It’s better to replace the bath with a shower.

What to do in the late postoperative period - When to see a doctor

If for any reason you ignore your doctor’s recommendations regarding post-operative recovery, then you will definitely have problems for which you need to consult a doctor for help! So, when do you need to see a doctor urgently!?

• If the hand becomes cold and/or too pale.
• The swelling becomes tighter and denser every day. Moreover, the swelling is quite for a long time may be completely painless, but this does not mean its safety - you can miss “precious” time.
• If you begin to feel weakness in your arm, as well as stiffness in your elbow and/or shoulder joints.
• If the swelling increases sharply.
• If the swelling becomes “mosaic”, that is, the arm swells in separate areas, and not completely.

IMPORTANT: “If you have venous insufficiency, then after breast removal surgery in order to prevent irreversible pathological changes in the soft tissues of the arm, you need regular medical and preventive examinations” - this is not even discussed, unless of course you want to return to normal/full life.

REMEMBER – timely consultation with a doctor will save your life! Diagnostics and consultation are carried out only during an appointment with a doctor in the clinic. Absentee diagnosis by telephone or email is not provided.

Doctors' visiting hours are from 10.00 to 17.00.

Saturday - from 10.00 to 13.00

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The material was prepared by Natalya KOVALENKO. Website illustrations: © 2014 Thinkstock.

Currently, surgery to remove breast cancer is one of the main treatments for this malignant neoplasm. This is the most common all over the world. In the general population it is second only to lung cancer.

Surgeries for breast cancer remove a colony of atypical (irregular) cells from the body. This saves the body from the development of tumor metastases, increases the duration and quality of life.

Depending on the amount of healthy tissue removed along with the tumor, operations are divided into:

1. Organ-preserving. The tumor is completely removed within healthy tissue. Whenever possible, the best cosmetic effect is achieved.
2. Radical. Complete or partial removal of the mammary gland is performed.

Operations preserving the integrity of the organ

Lumpectomy is relatively quick compared to other methods. A small arc-shaped incision a few centimeters long is made. An electric scalpel is often used for this. This allows you to reduce blood loss during treatment and achieve a better cosmetic effect in the future.

Then the tumor itself is removed along with a small area of ​​healthy tissue surrounding it. As a result, it is possible to preserve the mammary gland. This is very important, especially for young women. Disadvantages include possible postoperative deformation and changes in the volume of the gland. Recurrence of malignant neoplasm is possible.

Sectoral resection of the mammary gland is one of the most common organ-preserving operations. Sometimes it is called the Blokhin operation. It is most often performed under general anesthesia. Local anesthesia with Novocaine or Lidocaine is used. The operation is performed for small tumors affecting a small part of the gland. Approximately 1/8 to 1/6 of its volume is removed.

Subtotal resection with lymphadenectomy. During this operation, 1/3 or even half of the mammary gland is removed. Simultaneously with excision of tumor and glandular tissue, the pectoralis minor muscle and lymph nodes (subclavian, subscapular) are often removed.

Cryomammotomy is one of the newest methods of treating patients diagnosed with breast cancer.

First a small incision is made. Then directly to tumor cells a special probe is inserted. The probe tip temperature is around -100-120°C. The tumor quickly freezes and turns into an ice ball frozen to the cryoprobe. This design is easily removed through a small incision through the chest.

This procedure is performed in rare cases when the tumor size is small and.

Radical operations

Halstead mastectomy is performed under general anesthesia. After providing surgical access, the glandular tissue is removed by incising the skin and subcutaneous fat. The pectoralis major and minor muscles on the same side are then removed. It is necessary to remove the subscapular tissue, in which small metastatic foci are often found.

The axillary tissue behind the pectoral muscles is removed at all 3 levels.

Urban mastectomy is similar to the technique described above. This is complete removal of the mammary gland. In addition to this, the lymph nodes located on the sides of the sternum are removed. The sternum is a flat bone located in the center chest front.

Patey's mastectomy is a modified version of the classic mastectomy. Complete removal of the glandular tissue of the mammary gland and pectoralis minor muscle is performed. Distinctive feature operation is that the pectoralis major muscle and fatty tissue.

Modified Madden mastectomy differs from previous options in that after removal of the breast itself, the underlying pectoral muscles are preserved. The pectoral fascia, axillary, intermuscular and subscapular tissue are removed. At the same time, the risk of further development of metastases in the lymph nodes located in the tissue is eliminated.

Breast amputation is an operation to remove the gland itself while completely sparing the underlying tissue.

Main indications for breast removal

The tumor should be clearly visualized on images taken using a computed tomograph or X-ray machine. Special attention is given to patients in whom the tumor is found in several places at the same time, for example, in different lobes of 1 gland. In this case, 1 of the radical operations is considered priority.

If a tumor recurs after a lumpectomy, it is recommended radical mastectomy. Radical intervention is recommended for women who have contraindications to chemotherapy concomitant with lumpectomy.

In patients with very small breasts, breast-conserving surgery is not advisable.

This is due to the fact that after removal of the tumor focus, significant deformation of the mammary gland often occurs with a change in its volume. For many women this is unacceptable from a cosmetic point of view.

In some cases, mastectomy, regardless of the option, is combined with radiation therapy. This is necessary when a large number of lymph nodes are affected by metastases, or when the tumor is large (more than 5 cm in diameter). In the presence of multiple cancerous foci in the glandular tissue, a course of radiation therapy is carried out in the postoperative period.

A special study in the laboratory of the removed material along the edges of the excised tissue sometimes reveals cancer cells. This is an indication for postoperative radiation therapy.

How is the operation performed?

Surgery to remove breast cancer lasts on average 1.5-2 hours. The operation, with the exception of minimally invasive ones, is performed under general anesthesia. The patient is first placed on the operating table. The arm on the affected side is taken away from the body perpendicularly and placed on a stand.

Initially, an incision is made along the entire circumference of the gland in the shape of a semi-oval. The doctor then separates the skin from the subcutaneous fat. Often, dissection and subsequent removal of the pectoral muscles are performed. Then, if necessary, certain muscles are moved to the side. This makes it possible to remove cancerous lymph nodes, which are located, for example, in the armpit or under the collarbone.

Each lymph node removed mandatory sent for research. After removing the planned volume of tissue, drainage must be installed, which will allow the resulting fluid to flow out in the early postoperative period.

Drainage most often takes the form of a small rubber tube. On final stage During surgery, it is necessary to stop bleeding in the surgical wound, if any. The surgeon then sutures the surgical wound.

Sometimes during surgery it is necessary to remove significant areas skin along with glandular tissue. This in some cases complicates the process of suturing the edges of the wound at the final stage of the operation. The surgeon uses special releasing incisions to ensure normal wound healing. They are made shallowly in the skin on the sides of the surgical wound.

Currently, techniques have been developed to perform operations with maximum preservation of the skin.

Regardless of which type of surgery was used, patients often complain of loss of sensation in and around the wound area. This is due to the intersection of the sensory nerves located in the skin with the surgeon's scalpel. This symptom is associated with both minimally invasive and radical mastectomy.

Over time, sensitivity is almost always restored. Another unpleasant consequence of the operation may be excessive sensitivity or tingling in the area of ​​intervention. This is also due to irritation of nerve endings during surgery. The unpleasant sensations disappear after a while.

The choice of a specific type of operation is made by a breast surgeon after a thorough examination. It is necessary to establish the exact location of the tumor, its size and, using laboratory methods, finally confirm the diagnosis. How to determine the presence of a tumor and determine its type.

With radical methods, hospitalization in an oncology hospital or in a specialized department is mandatory. The patient, taking into account the preoperative preparation, the operation itself and the postoperative period, remains in the hospital for about 2-3 weeks.

If plastic reconstructive surgery is performed in addition to the main operation to remove breast cancer, the length of stay in the hospital increases. When performing minimally invasive interventions (for example, lumpectomy), the length of hospital stay can be shortened at the discretion of the attending physician. In the future, outpatient monitoring is necessary.

Manipulation of the mammary gland, especially its complete removal, is very stressful for a woman. It is necessary to conduct a thorough examination, establish an accurate diagnosis and, if possible, implement the most gentle option. Today, numerous methods of breast replacement after mastectomy are available.

And the most significant reason for this tragic fact is the late diagnosis of breast cancer relapses and the rapid progression of the disease after radical treatment.

Recurrence of breast cancer is the resumption of the tumor process within 6 months or more after antitumor treatment. In most cases, it occurs 3-5 years after completion of treatment, but in many the disease recurs within 1 year.

According to medical oncology statistics, even before the start of primary treatment, about 60% of breast cancer patients have either diagnosable or preclinical (non-diagnostic, “dormant”) micrometastases. Subsequently, cancer relapses affect up to 85% of patients, most of whom suffer from metastasis to the skeletal bones.

Young women under 35 years of age are most susceptible to relapse of the disease.

The mortality rate for recurrent breast cancer over 5 years ranges from 50 to 100%, many patients die within 1 year.

In modern oncology, a woman who has lived 5 years without recurrence of cancer after surgery to remove the mammary gland is considered to have passed the milestone of five years of relapse-free survival (RFS) and is in remission.

The degree of cure of the disease is determined only after 10 years without relapse of cancer after antitumor treatment. But even this period for breast cancer is not an objective indicator - there are cases of resumption of the cancer process 20 and even 25 years after supposedly successful treatment.

Unfortunately, awareness of the diagnosis and treatment of breast cancer is accompanied by great suffering for women. After diagnosis, severe psychological stress, most women experience a state of duality. On the one hand, it is necessary to go through difficult treatment, undergo mutilation surgery (breast removal), but remain alive, despite the consequences for work and family life; on the other hand, it is impossible to come to terms with an operation to remove the mammary gland, which turns you into a “freak”. Sometimes this leads to the breakdown of a family if the husband or loved one is not so strong in spirit and gives up in the face of a difficult life situation just when the woman especially needs their love and support.

After a mastectomy and other treatment methods, already at home, a woman with a “sore” arm and a suture at the site of the operation to remove the mammary gland, weak, deprived of the opportunity to perform many household duties, is overtaken by a second psychological shock, which, as it seems to her, deprives her of any hope of return to the old life. Oncologists call this situation a psychological collapse, since breast removal “knocks out” most women from their usual public and social environment and leads to serious changes in their psyche and lifestyle. Such a crisis situation requires a change in life position, a woman reconsidering her attitude towards the world around her, the words and actions of loved ones and acquaintances.

Helping a woman after a mastectomy cope with these difficulties is the main task of attending physicians, friends, family, and colleagues, since it is during this period that the woman’s future lifestyle in the family and society is formed. Oncologists believe that the microclimate in the family depends on the patient’s attitude towards her disease: the less a woman dramatizes the situation of breast removal, the more likely she is to receive support from her family. First, you should analyze your previous life and try to identify the factors that contributed to the appearance of breast cancer and, if possible, eliminate them.

After a mastectomy, anatomical and physiological disorders occur in the body, which can lead to partial disability. The question arises: how to live on, live long, have a happy family, work actively?

So, what needs to be done after a mastectomy to avoid recurrence of breast cancer, to increase the body's defenses, to feel good, to work at full capacity and to enjoy life?

• do not waste valuable time during oncological diseases, relying only on passive medical supervision, as well as the use of any supposedly anti-cancer dietary supplements, herbal infusions and other “miraculous” remedies, and it is MANDATORY to undergo specialized treatment according to the “Radical” program of the complex antitumor System “ONCONET”. Take care of yourself and your loved ones! Save your life and health! Then it may be too late! ;
• change your daily routine;
• change your diet;
• reset excess weight and stabilize it;
• engage in physical therapy;
• learn to relieve physical and psycho-emotional stress;
• take care of your appearance;
• do what you love;
• undergo regular medical examination.

Recovery physical strength, strengthening nervous system necessary:

• sleep for 7-8 hours with an open window or vent;
• before going to bed, take a warm shower, directing the water jets primarily to the sore spots;
• Place the sore arm on a pillow in bed so that the arm is elevated (this normalizes lymph circulation and its outflow);
• sleep on your back or on the side opposite to the operated side, so that your weight during sleep does not compress the blood vessels of the arm from the side of the breast removal site;
• when pain shooting in the area of ​​surgery to remove the mammary gland, arm, shoulder area, you should consult a doctor (this may be a symptom of bronchoplexitis - inflammation of the brachial plexus);
• do not lift or carry heavy objects, if possible, do not overexert your arm from the breast cancer removal side. As the load increases, the muscles require more oxygen, which increases the blood flow to the arm, which is already overloaded with venous blood and lymph, while the outflow from it is difficult;
• It is recommended to limit the load on the arm from the operation - up to 1 kg for one year, up to 2 kg for four years and up to 3-4 kg throughout life. It is better to carry the bag on the shoulder of your healthy arm;
• Avoid any work that requires a prolonged inclined position with arms down. Such restrictions are needed to prevent stagnation of lymph in the lymphatic vessels of the hand;
• after physical work, be sure to do gymnastics, self-massage of the hand (stroking from the fingers of the hand to the armpit), give it an elevated position at an angle of 10°-15°;
• when working on summer cottage, washing, washing dishes, especially with the use of strong detergents, it is recommended to use protective gloves;
• sew with a thimble;
• avoid mosquito and bee bites by using repellent for protection;
• It is not recommended to give injections, donate blood for analysis, or measure blood pressure on the arm on the side of the breast removal operation;
• The arm on the breast cancer removal side should not be pinched: avoid tight cuffs on blouses and nightgowns, make sure that the armholes of the clothes are not too narrow, and that the bra straps should not cut into the shoulder. Rings, bracelets and watches should be held loosely on the hand, without being wrapped around;
• avoid burns during cooking, do not allow sunburn. In summer, wear a hat and long sleeves (to protect from sun rays);
• Do not use hot water when washing dishes or taking a bath. After a mastectomy, a sauna or steam room is contraindicated, and it is recommended to replace washing in the bathroom with a shower;
• protect the hand on the breast removal side from cuts, burns, abrasions, cracks, scratches caused by animals and plants. These precautions are important for preventing erysipelas. Erysipelas leads to the appearance and increase in swelling of the hand;
• If you receive a hand injury from breast cancer removal, you must wash the wound with running water and treat it twice with an antiseptic solution (iodine, 0.01% chlorhexidine bigluconate, 70-degree alcohol solution). If the hand at the site of injury turns red, pain appears, body temperature rises, or swelling of the hand increases, you should consult a doctor;
• after work, you need to remove your bra with a prosthesis, give your body a rest, and put on loose cotton clothes;
• protect the area of ​​the operation to remove the mammary gland with your second, healthy hand in transport, in the market, in crowded places.

During the recovery period (7-8 days after mastectomy), it is recommended to carry out a complex of therapeutic exercises to restore the maximum range of movements in the arm on the breast removal side, maintain correct posture, coordinate movements, full breathing, and normalize general condition. It is better to perform exercises twice a day - in the morning and in the middle of the day. Pool exercises are very effective for restoring motor function of the arm after breast removal. They can be started 2-3 months after breast removal surgery.

Indications and performance of breast removal surgery

Removal of the breast is called a mastectomy; breast removal can be complete or partial. According to indications, the pectoral muscle and lymph nodes in the armpit can be removed. The main indication for this surgical intervention is breast cancer (BC). Breast amputation can be a solution to the problem of oncology or a way to somewhat prolong life with the disease. Breast cancer is currently the leader among all forms of cancer in women, and if removal of the mammary gland is proposed, one must agree without hesitation.

Factors in the development of breast cancer

Predisposing factors are:

• heredity;
• hormonal imbalance;
• microtrauma of the breast;
• degeneration of fibroadenoma (benign process), existing cysts;
• stagnation of milk during breastfeeding.

Prevention as such does not exist, there are many factors, it is impossible to single out one main one separately. All that remains is regular examination at the mammologist.

Prevention as such does not exist, there are many factors, it is impossible to single out one main one separately.

The mammary gland can be amputated for the following indications:

• tumor size exceeds 1 quadrant;
• radiation or chemotherapy were unsuccessful;
• the tumor is larger than 5 cm;
• after the breast resection, the affected area was not completely removed, so a complete amputation is required;
• contraindications to radiation therapy;
• extensive phlegmon of the mammary gland;
• mastopathy with multiple lesions of the gland by cysts or nodes.

Removing the breast on one side reduces the risk of cancer, but does not guarantee that it will not appear on the other.

Removal of mammary glands (video)

Tests and preparation for surgery

• blood and urine tests;
• Ultrasound of the gland;
• blood test to determine coagulability;
• biopsy;
• mammography.

During the upcoming operation you should:

• 2 weeks before it, stop taking anticoagulants;
• preventively, the evening before the operation, the woman is given antibiotics;
• 12 hours before surgery the patient should not eat;
• cleanse the intestines with an enema.

Types of operations

The following types of surgical intervention can be distinguished:

1. General breast removal surgery involves complete amputation, including the nipple and areola. The pectoral muscles are left. If the tumor does not exceed 2 cm in size, then the nipple and areola are not removed.
2. Subcutaneous - in this case, the tumor should be next to the areola no further than 2 cm; The gland and lymph nodes are removed, but the nipple and areola remain. An incision is made around the areola. Radiation therapy is required afterwards.
3. Partial (lumpectomy) - only the damaged area and some healthy tissue around it are removed. For stage 1 and 2 cancer, lymph nodes are also removed, long-term results are good.
4. Radical mastectomy according to Halsted - it is performed for extensive lesions: the gland, both pectoral muscles and axillary lymph nodes, fatty tissue from the armpit, under the collarbone and scapula are removed. The operation is radical, but more traumatic. Today this method is rarely used, only in the later stages of cancer, when the tumor grows into the pectoralis major muscle, infiltrates it and causes swelling. The incision is closed with the remaining skin. The scar after the operation is cm. There are many complications after such an operation.
5. Radical improved - amputation of the mammary gland is performed: everything is removed, even small ones blood vessels lymph nodes, but the incision is made in the form of an incision around the areola. Through it, the gland tissue is removed. The scar remains transverse.
6. Radical expanded - to the removed gland, pectoralis major muscle, lymph nodes, removal of the pectoralis minor muscle and resection of the chest wall where the tumor has grown is added.
7. Quadrantectomy - it is performed if the tumor occupies a quadrant of the breast. A separate incision is then made through which the axillary lymph nodes are removed.
8. Patey's modified radical mastectomy - 2 semi-oval incisions are made around the gland, from the parasternal to mid-axillary line (axillary lines). The gland with the fascia of the pectoralis major muscle is removed from this incision, the muscle itself is not touched; the pectoralis minor muscle is removed or pulled to the side to open access to the lymph nodes in the armpit; and then the gland and nodes are removed as a single block. A drain is inserted and the wound is sutured. The pectoralis major muscle is preserved, so the operation is not so traumatic, the functions and cosmetic appearance of the remaining muscles are better preserved. Currently, this model of operation is most often performed, which has become the gold standard in the surgical treatment of breast cancer.
9. Extended radical mastectomy according to Urban - a technique similar to Halstead, but here the parasternal lymph nodes are additionally removed. To do this, 2-3 costal cartilages are removed along the parasternal line. This method has no advantages compared to the Halsted method. It is also rarely used, only if there are metastases to the specified lymph nodes.

All operations are performed under anesthesia. Depending on the volume of removal, the procedure time can range from 1 to 3 hours or more. Guarantees complete cure the operation does not work. It all depends on the type and size of the tumor, its stage, etc. Often after operations, chemotherapy or radiation therapy may be prescribed according to indications to consolidate the results. Removal of mammary glands in women can, according to indications, be carried out bilaterally, when both are removed at once.

Metastases to the lymph nodes during any operation reduce 5-year postoperative survival, so attempts are made to remove them.

When mutating genes are detected, women are under the dynamic supervision of doctors to identify early stage cancer

Prophylactic mastectomy

The hereditary nature of breast cancer implies a mutation of the BRCA1 and BRCA2 genes. This discovery led to the development of preventive breast removal. In the United States, an example was set in 2013 by Angelina Jolie, who had her mammary glands removed bilaterally when it turned out that she had an 80% risk of breast cancer due to heredity. In Russia, preventive removal is not practiced. When mutating genes are identified, women are under dynamic medical supervision to identify the early stage of cancer. Preventive removal of the mammary glands is only possible when there is a risk of developing cancer with a possible complication.

Breast surgery (video)

Postoperative period

After 1.5 days you are allowed to walk, but in the first days there is a pronounced pain syndrome. Patients should not make sudden movements or raise their arms up. You cannot force physical activity.

After removal of the drainage tubes, fluid may accumulate at the surgical site, but it usually resolves on its own. In other cases, the liquid is removed by a doctor during dressing by puncture. A thick bandage is placed around the chest and must be worn for a month. The bandage forces the skin to fit tightly to the muscles at the surgical site so that lymph does not collect there. But it happens that the lymph still collects; in such cases, a puncture is periodically performed by a surgeon at the place of residence. In obese women, lymph takes longer to collect. Sutures are removed 2 weeks after surgery. If there are no complications, the woman returns to her rhythm of life after 1.5-2 months. At the same time, you can resume sexual activity.

Consequences of mastectomy

In the first days after surgery, there is a feeling of discomfort in the neck and back, numbness of the arms, shoulders, chest and armpits; At the site of surgery, the skin becomes tight and rough. Arms and shoulders may become temporarily weak. These sensations remain irreversible in rare cases. In connection with these phenomena, a few days after the operation they begin to do special therapeutic exercises.

Removal of lymph nodes under the armpits often leads to a slowdown in the outflow of lymph and the development of swelling - lymphedema. Sometimes this is irreversible. This complication may appear immediately or after several months.

The hand on the operated side must be constantly protected from injury. Many women are interested in restoring their breast shape. Such reconstructions can be performed during surgery or 9-12 months after surgery using a silicone implant or using your own tissue from another part of the body: skin, fat and muscle can be taken from the abdomen, buttocks or back. Options and expected results are discussed with plastic surgeon. The reconstructed breast, even if visually similar to a healthy one, will still differ in sensitivity and to the touch.

Removal of mammary glands in men

Mastectomy surgery can also be performed on men. They may also develop breast cancer (carcinoma), although this is extremely rare. They may also have gynecomastia, which is treated with hormones. If there is no effect, the breast is also removed. In case of obesity, the breasts are not removed, only liposuction is performed.

Complications after mastectomy

Complications may include:

1. Hematomas and postoperative bleeding.
2. Suppuration of the wound.
3. Erysipelas is the most common and dangerous complication of lymphedema. In this case, it develops bacterial infection skin and subcutaneous tissue, which in turn causes thrombophlebitis and abscesses. Erysipelas can be treated well if treated in a timely manner.
4. Painful scars and welts.
5. Neuropathic pain syndrome in the form of tingling, numbness and stabbing pain in chest wall, armpit, arm.
6. After 4-6 weeks, lymphedema may develop.
7. Frozen shoulder syndrome - arm movements in the shoulder joint are limited and painful. This can develop several months after surgery and is due to damage to nerve endings during surgery.

Contraindications after surgery

It is strictly forbidden to shower or wash yourself before the stitches are removed. It is necessary to exclude physical activity, you cannot sunbathe and overheat (forever), swimming in the pool is prohibited for 2 months. You cannot sleep on your side on the side of the operation; you need to regularly massage your arm - stroking from your fingers to your shoulders. After removing the stitches, you need to start doing gymnastics: raising your arms to the sides and up; placing the hand on the affected side behind the head; bend your elbows and raise your elbows.

Is it possible not to remove lymph nodes? This is ruled out because the risk of cancer returning increases.

Do I need to see an oncologist after surgery? Visiting a doctor is mandatory once every 3 months. If there are no complications, then later visits with regularity once every six months. It is especially important to see a doctor for women with venous insufficiency because they often develop lymphedema.

A visit to the doctor becomes urgent if:

• pallor and cyanosis of the hand appeared;
• the hand became swollen, tight and tense, cold;
• pain appeared and it became difficult to move my arm.

For swelling of the hand, treatment is prescribed:

• benzopyrones and nicotinic acid to relieve swelling, inflammation and improve blood circulation;
• Olive and jojoba oils are used to nourish and moisturize the skin of the hand;
• to normalize the outflow of lymph, you need to wear a special elastic sleeve (sold in a pharmacy);
• protect your hand from injury: you can’t even measure blood pressure on it, give injections, IVs, take tests, allow mosquito bites, bruises;
• exclude any physical work.

As soon as lymph stops accumulating, you can go in for sports and do your usual work at home. Young women can give birth, but after consulting a doctor.

After surgery, elderly people are recommended to purchase special underwear with a removable prosthesis to balance the load on the spine. A woman after a mastectomy is given lifelong disability group 3. After surgery, adjuvant or prophylactic therapy is always prescribed, which complements beam method and surgery. This is done to prevent micrometastases caused by breast cancer. This includes hormones, chemotherapy, targeted therapy with special drugs for targeted action only on cancer cells. Thus, mastectomy is today the only way to help women solve their problem or prolong life.

What types of breast reconstruction are there after mastectomy?

Breast reconstruction is a big deal. During the reconstruction process, tissues of the back and anterior abdominal wall, as well as the second mammary gland, if its shape needs to be adjusted, may be affected.

Typically subject to restoration:

• volume of skin and subcutaneous fat in the area of ​​the removed mammary gland;
• the volume of tissue around the reconstructed mammary gland if adjacent tissue and the pectoralis major muscle were removed during the mastectomy operation;
• nipple-areolar complex;
• The shape and size of the second breast can be adjusted to improve appearance bust and eliminating asymmetry.

Of all the known plastic surgery techniques, almost any can be used:

• use of Spanderov and thoracic endoprostheses;
• movement of skin, subcutaneous fat and muscles to the area of ​​the reconstructed breast;
• lipomodelling;
• laser polishing of scars;
• tattooing of the areola area;
• In some cases, it is possible to use vacuum devices to stretch the skin in the area where breast reconstruction is being performed after a mastectomy.

As you can see, breast reconstruction requires a large number of skills from a plastic surgeon, so such work should not be trusted to untested people.

What is it for

Absence of the mammary gland is not only psychological problem. Although in most cases it is psychological discomfort that is the motivator for most patients who decide to undergo plastic surgery.

In addition to problems associated with an unaesthetic appearance of the bust after a mastectomy, there may be:

• imbalance of the load on the thoracic spine on both sides: where the mammary gland is preserved, the load will be greater;
• secondary changes in the osteoarticular system associated with an imbalance of the load on the spine, which are expressed by poor posture, drooping of the shoulders, and curvature of the spine;
• consequences of spinal curvature: disruption of the functioning of the chest organs - heart and lungs.

Therefore, after a mastectomy, this is not only a way to regain self-confidence, but also an excellent preventative against a number of chronic diseases cardiovascular and respiratory systems.

Video: Life after mastectomy

What determines the volume of plastic surgery during breast reconstruction?

Not all plastic surgeon patients undergo breast reconstruction operations in the same way. The volume depends on a number of criteria.

• The volume of tissue removed during surgery for cancer.

Depending on the extent of the cancer, varying amounts of tissue may be removed.

The simplest situation is the removal of local formations while preserving the healthy part of the mammary gland. In this case, retracted scars and areas of retraction are formed at the sites of removal of nodes and tumors.

All breast tissue may be removed, preserving the skin and subcutaneous tissue covering the breast. A relatively easy option for subsequent reconstruction. Currently, this type of cancer surgery is rare. In most cases, it is used to prevent breast cancer in people with a genetic predisposition to developing the disease.

Angelina Jolie, whose mother died of cancer, performed this operation on herself. Endoprostheses are installed in place of the removed glandular tissue. Total breast removal is the most common way to remove breast cancer in women.

In cases where there is a risk of spread of metastases, the entire mammary gland, pectoralis major muscle, and subcutaneous fatty tissue of half the breast are removed in order to remove the lymphatic vessels and lymph nodes to which lymph flows from the diseased mammary gland. This option is the most difficult for subsequent bust restoration and requires the special skill of a plastic surgeon.

The patient should be able to undergo the next operation and anesthesia without complications. Here you need to take into account that contraindications for plastic surgery will be much more stringent than for surgery performed for health reasons (for cancer, for example). And what did not prevent surgical treatment of cancer in the past may become serious contraindication for reconstructive surgery on the mammary glands.

• The appearance of the second breast and the client’s wishes regarding the future size and shape of the bust.

It’s only at first that it seems like there is no life after a mastectomy. Over time, while thinking about and discussing with a plastic surgeon the details of the upcoming reconstructive surgery on the mammary gland, there is often a desire to “tidy up” the healthy mammary gland, if there is a sign of prolapse, there is a desire to reduce or increase the size of the bust.

One of the reasons why many agree to this is the reluctance to subsequently undergo another anesthesia, when it will be necessary to undergo surgical breast lifting, breast reduction or enlargement.

Do you want that after plastic surgery there are no traces of surgical intervention left on your mammary gland? Find out more about seamless increase breasts

Read all about female breast, recovery after childbirth and breastfeeding at this link.

How can removal be carried out?

Until recently, it was believed that it was optimal to first remove the mammary gland, and perform reconstructive surgery only a year after the mastectomy.

Some surgeons still believe that this is the best way to prevent the development of metastases and cancer recurrence. But not all patients find it psychologically easy to wait that long. For some, the physical defect becomes so significant that even the fact of getting rid of cancer is no longer pleasing.

Family relationships are deteriorating. According to a number of reports from European authors of opinion polls and studies, 70% of marriages break up in the first two years after mastectomy. As a result, there is no disease, but the quality of life leaves much to be desired.

Therefore, in most cases, reconstruction is now performed simultaneously with removal of the mammary gland, if not serious problems with health and contraindications to extended surgical intervention.

How soft tissue is restored in the area of ​​the removed mammary gland

There are several options for restoring tissue volume in the mastectomy area.

An expander can be used

An expander is a special device that is installed in the area of ​​breast reconstruction for a period of 3 to 6 months. It stretches the skin and forms a cavity sufficient for subsequent placement of the implant. Expanders are included in the list of products offered by most companies involved in the production of breast implants. Two-step algorithm and breast implant shown in the video.

Video: Breast reconstruction (expander + implant)

It is placed under the skin and filled with liquid over a period of time. The liquid is injected using a syringe. The procedure is performed on an outpatient basis.

Advantages of using an expander:

• much less traumatic operation compared to transplantation of a musculocutaneous flap;
• The final volume of skin required for breast reconstruction is achieved twice as quickly as using a vacuum system.

Disadvantages of using an expander:

• The need for frequent visits to the doctor for injections;
• Unnatural breasts in appearance and to the touch;
• There is a risk of necrosis (death) of tissue over the expander if the skin is stretched too quickly;
• The implant is located directly under the skin, therefore there is a risk of rapid development of ptosis; there are restrictions on the use of a number of implants in terms of gel density, so that the final result is as close to natural as possible.

A vacuum device may be used to shape excess skin in the area where breast reconstruction is planned. For such cases, the Brava system has been developed. You need to wear it for a long time. You need to use it for an hour every day to get the desired result.

The essence of the method is that a special dome-shaped cup is placed on the area of ​​the mammary glands. A vacuum is created under the cup, thanks to which the skin is constantly in a taut state and gradually stretches.

The advantages of the method are that:

• performed simultaneously with liposuction;
• the method allows the use of both implants and transplanted own fat to restore the volume of the mammary gland;
• if fat grafting is used, there is no scarring.

The disadvantages of the method are that:

• you need to wear a special device on your chest for many months;
• it is difficult to achieve significant chest stretching to big size implant;
• there is a risk of stretch marks and spider veins.

The whole technique consists of three stages:

Stage 1 - preparatory. It involves wearing a vacuum system for a certain period of time every day, hourly. The system can be worn both day and night.

Stage 2 - fat tissue transplantation. Fat is removed from areas where there is usually excess fat using liposuction. Fat tissue is moved to the breast area using injections.

Stage 3 is the final stage. The Brava system must be worn for another 3-4 weeks in order to increase the survival rate of the transferred adipose tissue.

Musculocutaneous flap transplantation

The flap can be transplanted from the back (latissimus dorsi muscle), or the front abdominal wall(rectus abdominis muscle).

• mammary gland natural in shape and touch;
• There are no problems associated with the use of implants, such as implant displacement or the need for replacement.

• long-term anesthesia (4-5 hours);
• very high invasiveness of the operation;
• long period of rehabilitation;
• there is a risk of necrosis of the transplanted musculocutaneous flap and its subsequent rejection;
• significant postoperative scars.

Combined technique

To reconstruct the breast, a skin graft from the buttock, abdomen or back and an implant are used.

Restoration of soft tissue around the removed mammary gland.

If an extended operation is performed to remove not only the mammary gland, but also the adjacent soft tissues of the breast, then during reconstruction it is necessary to restore their missing volume from the surgical intervention.

Typically, restoration is performed by transplanting fat tissue, which is taken from those places where there is excess fat.

Methods for restoring the nipple-areolar complex

Without restoration of the nipple and areola, breast reconstruction will be considered incomplete, since it is important for a woman to look good both with and without clothes.

There are three main ways to recreate the nipple and areola:

• the areola is recreated from the areola tissue from the healthy side;
• the skin of the labia minora is transplanted if it is pigmented;
• the nipple is formed from the tissue of the reconstructed mammary gland, and the areola is pigmented using tattooing.

Correction of the second breast

In order to eliminate asymmetry and improve the shape of a healthy mammary gland, a large number of methods are used:

• mastopexy;
• mastopexy with breast augmentation with an endoprosthesis;
• mastopexy with breast reduction.

Less commonly used methods are breast lift with threads and the use of fillers.

What plastic surgeries are performed on nipples and areolas? Read about all types of plastic surgeries performed for inverted nipples in the article - nipple correction.

Breast ptosis is a gradual drooping of the mammary glands and loss of their volume. See photos here.

Contraindications

• presence of infectious diseases;
• the presence of a tumor process of any stage and localization;
• serious illnesses internal organs, in which their function is impaired;
• diabetes;
• blood clotting disorder;
• age under 18 years;
• less than a year from the end of lactation;
• general serious condition of the patient;
• obesity;
• doubts about the need and advisability of reconstructive surgery on the part of the patient.

Preparing for surgery

• surgeon consultation;
• laboratory and instrumental examinations to identify possible contraindications to surgery;
• It is forbidden to drink alcohol two weeks before surgery, as this can lead to problems with anesthesia and recovery from it;
• It is recommended to stop smoking at least two months before surgery, especially if musculocutaneous flap transplantation is planned, to prevent problems with delayed healing and necrosis.

Complications

• bleeding;
• swelling;
• necrosis of the skin flap or skin over the expander;
• scars;
• delayed healing;
• infection;
• complications associated with wearing implants (capsular contracture, rotation and displacement of the implant, and others).

Rehabilitation

Time, necessary for the body for complete recovery after surgery depends on the volume of the operation itself. If we talk about the Brava method, it is the least traumatic method, which requires sick leave for a maximum of three days during liposuction and fat tissue transplantation.

Full restoration of performance occurs 2-3 weeks after the operation and does not require any restrictions, except for the ban on thermal procedures. The use of expanders and endoprostheses essentially involves two operations. During the first, an expander is installed; during the second, it is removed and replaced with an implant.

After each operation, there is a need to limit exercise, take painkillers, and observe a ban on thermal procedures and sunbathing. After installation of implants, it is recommended to wear compression garments.

The rehabilitation period is about 4 weeks. If we are talking about the formation of the mammary gland using the method of moving a skin-muscular flap, then the rehabilitation period is often difficult and long.

• the period of stay in the clinic is about days;
• sutures are removed on day 14;
• intense pain is possible, which gradually subsides towards the end of the rehabilitation period;
• ban on heavy lifting and intense physical activity for a period of at least 6 months;
• wearing a bandage or compression garments for at least six months after surgery;
• avoiding sexual activity for 3-6 weeks after breast reconstruction.

The recovery period in this case can be from 6 weeks.

What is false gynecomastia, symptoms, and how you can get rid of it, in this article. What methods exist in modern medicine on breast lift without implants, read the link.

Are you wondering if you can feed silicone breasts child? That way.

Photos before and after

Your feedback

I don’t understand why inserts in a bra are bad? Such a serious operation, and even with anesthesia.

What about without a bra? And it’s good if an even scar remains. And if the scars are rough and thick. You'll have to clean it up anyway. And it won't always work with a laser. This means it’s still an operation, and it’s still pain relief.

I did it for myself. To be honest, I was very afraid and very doubtful. And she did it only for her husband, because she was very shy about him. The second operation, which was for restoration, took place more than a year after removal. All the time I just wore a pad sewn into my bra, without any silicone inserts. I can say that the second operation was worse than the first (skin, fat and muscles were transplanted from the back). Maybe because it’s so complicated, or maybe because all this hassle with hospitals has exhausted me. And my husband wasn’t particularly supportive. Now I think that I would not agree to such a serious operation, since I am still recovering from it. What won me over was that there would be no problems with the implants later, but it would be better if I chose an expander.

But they didn’t take me for reconstructive surgery. They said because arterial hypertension and something with the heart rhythm. Now I am treating my heart and blood pressure and hope that they will take me for the second time.

The topic is very difficult, I was affected by this situation a year and a half ago, my left breast was removed, I am not married and have no children, a very large complex formed, at first I also put a small pad in my bra, but as with a young man, before intimacy I just had a stopper, In the end, I decided to undergo such a complex operation in order to improve my personal life, fortunately all the medical indications were in my favor! The best surgeon in Moscow, Sazhienko Vladimir, operated on me at the Beauty Trend clinic, the operation was easy and without complications for me, now everything is fine, I came to my senses and began to enjoy life again!)

is the most common female cancer. If detected early, the preferred method of treatment is surgery, and the patient will have to choose between an organ-preserving method, that is, lumpectomy (removal of only a dense tumor), or complete removal of the mammary gland (total mastectomy). Let's figure out how to make the right decision in such a difficult situation.

- one of the best breast surgeons in Israel. He heads the breast health center at the Soroka hospital and conducts private practice at the "" and the Assuta clinic. We asked him a few questions about the specifics of performing breast surgery for cancer.

What criteria are used to decide whether a patient needs to undergo a particular operation?

When deciding whether a patient needs surgery, we weigh factors such as the size of the tumor, the type of cancer and the extent of its spread to nearby lymph nodes and organs. It is important to understand that the surgeon’s recommendation does not oblige the patient to anything and, ultimately, final decision she accepts. Often a woman is guided by emotional and spiritual reasons when choosing a treatment method, and her decision does not always coincide with the surgeon’s recommendation.

Does a mastectomy have a higher success rate than a lumpectomy?

Today, in many cases, it is possible to achieve the desired result using lapmectomy without resorting to radical removal of the mammary gland. Just a few years ago, in cases of a large tumor, the patient was prescribed a mastectomy, but technologies in the field of surgery and breast reconstruction are rapidly developing. Today we can say with confidence that the percentage of achieving stable remission is the same among patients who underwent lumpectomy and those who underwent radical surgery, so the opinion that mastectomy is more effective is fundamentally wrong.

From your personal experience, can you note the tendency of patients to choose one type of surgery or another?

Recently, there has been an amazing tendency of patients to radical resection of the mammary gland, sometimes even both glands. My colleagues and I believe that the “culprit” for this is increased awareness of breast cancer, which in turn leads to exaggerated and not always justified fear. Nowadays, women constantly receive information about the threat of breast cancer: warning and explaining the problem on the radio, posters on the street, articles on women's Internet portals, and so on. Despite good intentions, this " advertising campaign"caused an unexpected effect - believing the arguments presented, women prefer radical surgery to avoid possible relapse of the disease.

Do you think Angelina Jolie's case has affected the way breast cancer is perceived?

Without a doubt. The spread of information about Angelina Jolie's medical history has led women to underestimate the emotional and physical difficulties associated with a mastectomy. They strive to follow the example of Hollywood stars and insist on radical surgery, even when the surgeon is categorically against it.

Is there a difference in aesthetic outcome after breast reconstruction following lumpectomy and complete reconstruction following radical resection?

As I noted earlier, the field of breast surgery and reconstruction has been rapidly evolving over the past few years. More recently, after a lumpectomy, the patient was left with significant scars and the aesthetic effect left much to be desired, so many women preferred a total mastectomy with complete symmetrical reconstruction. Today, new methods of oncoplasty allow for excellent reconstruction with a small and almost invisible scar, even after a lumpectomy.

In what cases is it still preferable to perform a mastectomy?

Breast surgeons recommend radical surgery to patients when several breast lesions are detected. malignant foci instead of one tumor. Also, when the disease is detected at a relatively advanced stage and we are talking about an aggressive and invasive tumor, mastectomy is preferred.

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Comments8

Thanks for the useful interview. Usually, when they interview someone, it has no informational value, it’s more about how good everything is. how everything is developing, how now we can do everything this way and that, and so on. Such interviews are, of course, interesting, but there is nothing concrete in them. It was in this interview that I received real useful information for myself, as if they had directly answered my question about what and how is best.

Wholesale imitation of stars in everything is the most utter stupidity a person can do. I don’t know how much it was really necessary to remove Angelina’s breasts, but it seems to me that it was more of a PR move than a necessity. In fact, all these stars sooner or later stuff silicone where it is necessary and not necessary, so a breast prosthesis in their minds is as it should be of age. But, I don’t understand why remove the breast if you can undergo treatment without it. The doctor says correctly, because of our emotions we often don’t understand what we are doing, but we need to think with our heads.

What and how to remove or not remove should be decided by the doctor. We are women, we always decide everything based on emotions, doctors working with us must take this into account, but they should not only recommend and offer us to decide something ourselves, but also help us do it right choice. Our men should help us calm our emotions and think with our heads. That's why loved ones are given, to help. And for a doctor, this is his duty. Every doctor should be a bit of a psychologist.

Women, I’ll tell you this - natural breasts are always better than any artificial ones, even if they are smaller and not so elastic, even if the shape has suffered mercilessly over the years of life. But the health of the woman you love is always more important for normality, so let them be silicone, let them dangle like spaniel ears, even if they are of any kind, it is important that they do not harm health. Therefore, take care of your health and you will be beautiful.

I think that a doctor should not recommend, but prescribe. The right to choose and freedom blah blah blah, all this is of course good, but it is not always necessary to give people this right in everything. A sick person is a sick person and is not always able to make adequate decisions. By giving such a patient the right to choose, we are practically signing his sentence or pushing him into the game of “roulette with life.” I remember a program about a girl who decided to enlarge her breasts. She was advised not to do this, she did not listen and is now crying because of the enormous problems that have arisen. In this situation, it’s the same with removal of the mammary gland. You cannot be led by the patient's emotions. Otherwise I really enjoyed the interview.