Name of the Procedure:

Mastectomy, Subcutaneous

Summary

A subcutaneous mastectomy is a surgical procedure that removes breast tissue while preserving the skin, nipple, and areola. It is primarily performed to treat or prevent breast cancer or to address non-cancerous diseases of the breast.

Purpose

The primary purpose of a subcutaneous mastectomy is to remove breast tissue to treat or reduce the risk of breast diseases, including breast cancer. It aims to eradicate cancerous cells or significantly reduce the likelihood of developing cancer while maintaining the breast's outer appearance.

Indications

• Diagnosis of breast cancer or a high risk of developing breast cancer (e.g., BRCA1 or BRCA2 mutation carriers).
• Benign breast conditions requiring tissue removal.
• Prophylactic measure for individuals with a strong family history of breast cancer.
• Gynecomastia in males.

Preparation

• Fasting may be required several hours before surgery.
• Medication adjustments may be necessary.
• Preoperative imaging (mammogram, ultrasound) and lab tests (blood work) are typically conducted.
• Discussions on anesthesia and post-operative care with the surgical team.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is asleep and pain-free.
2. Incision: An incision is made around the areola or under the breast.
3. Tissue Removal: Breast tissue is carefully removed, sparing the skin, nipple, and areola.
4. Closure: The incision is closed with sutures or surgical glue, and a dressing is applied.

Equipment includes surgical scalpels, retractors, and suturing materials. Specialized instruments for tissue removal and devices for anesthesia administration are also utilized.

Duration

The procedure typically takes 2 to 3 hours.

Setting

Performed in a hospital or surgical center.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technicians

Risks and Complications

• Common: Pain, swelling, bruising, infection.
• Rare: Bleeding, adverse reactions to anesthesia, changes in breast sensation, scarring. Complications are managed with medications, wound care, or additional interventions as needed.

Benefits

• Reduction in the risk of developing breast cancer.
• Treatment of existing breast cancer or benign breast conditions.
• Preservation of the breast's physical appearance.

Most patients notice an improvement in their overall health and a significant reduction in cancer risk shortly after recovery.

Recovery

• Patients are typically discharged the same day or after an overnight stay.
• Instructions include wound care, pain management, and avoiding strenuous activities.
• Full recovery usually takes 4 to 6 weeks.
• Follow-up appointments to monitor healing and discuss further treatments if necessary.

Alternatives

• Lumpectomy: Removes only the cancerous tissue but may require radiation therapy.
• Total Mastectomy: Removes all breast tissue, including the nipple and areola.
• Non-surgical treatments: Hormonal therapy, chemotherapy, radiation. Each alternative has its own benefits and drawbacks regarding treatment outcomes, recovery time, and impact on breast appearance.

Patient Experience

• During: Patients will not feel pain during the procedure due to general anesthesia.
• After: Post-procedure pain will be managed with medications. Patients may experience some discomfort, swelling, and limited mobility during initial recovery. Ensuring patient comfort through pain management and supportive care is prioritized throughout the recovery process.