Breast cancer is the most common cancer among women worldwide – it accounts for 16% of all cases of cancer among women. The survival rate after oncology in high-income countries is approximately 65%, and 40% in low.

Maria Gessen, Angelina Jolie, and many other women whose names are known to us, decided on this operation for the benefit of their health and long life. All these women were carriers of a mutant gene that provoked the development of the cancer : gene BRCA 1, BRCA 2.

    Which women are susceptible to cancer?

– Women who are carriers of the mutant gene, due to which breast and ovarian cancer develops.

– Women with a family history of mother or grandmother having oncology.

– Women with extensive benign lesions of the mammary gland, which can later degenerate into malignant.

– Patients who were exposed to irradiation of breast at an early age (in Hodgkin’s disease)

– Women who have had cancer of one breast in the past are more susceptible to have cancer and the second.

Today, preventive mastectomy is one of the best ways to prevent and combat cancer.

    Preventive mastectomy is a preventive surgery to remove the breast, adipose tissue and lymph nodes, usually performed simultaneously with breast reconstruction. The operation is performed in gynecomastia and in a genetic predisposition to breast cancer.

    Briefly about diagnostic investigations

– Clinical examination. Sometimes cancer is manifested by the presence of a “lump in the breast”. In most cases, these nodes are benign. However, since breast cancer is a fairly common occurrence, a woman who finds any nodule in her breast should see a doctor immediately.

– Imaging. These examinations (mainly mammography and ultrasound) are prescribed by the doctor as part of a systematic active detection or as a result of an examination with the identification of abnormalities in the chest. In some cases, MRI (magnetic resonance imaging) is performed.

– Biopsy and cell analysis. The taken tissue sample from the suspicious zone is sent for analysis to the laboratory. It is this study that allows you to clarify and confirm the diagnosis.

    How to prepare yourself for the operation?

Initially, you need to consult your doctor to identify possible contraindications. During the consultation, it is necessary to warn the doctor about taking any medications, even if they are just vitamins.

Before the operation, a prerequisite is the delivery of instrumental and laboratory examinations, which include:

– Complete blood count and urinalysis;

– Blood glucose;

– Blood type and Rh factor;

– Coagulation testing (coagulation time, INR, PTI, APTT);

– Biochemical analysis of blood (bilirubin, ALT, AST, total protein, urea, creatinine, C-reactive protein, liver tests, electrolytes (potassium, sodium, calcium);

– Blood test for HbsAg (viral hepatitis B);

– Total antibodies HCV (viral hepatitis C);

– Blood test for HIV and RW;

– Electrocardiogram;

– Consultation of GP

– Fluorography or chest X-ray results

Before the operation, the desired result is discussed and the selection of implants takes place.

    What are the contraindications for mastectomy?

– Acute infectious diseases in the acute stage

– Sub-or decompensated diabetes mellitus

– Oncological neoplasms located in the lower body

– Pregnancy and lactation

– Diseases of the blood system associated with insufficient coagulability

– Varicose veins

– Thrombophlebitis

– Diseases of the cardiovascular and respiratory system of moderate and severe degree

    There are several types of mastectomy:

1. The classical (Halstead) radical mastectomy. During this operation, the small and large pectoral muscles, mammary gland, fatty tissue and regional lymph nodes (axillary and subclavian) are removed. The wound is sutured and drainage is inserted, for the outflow of fluid in the early postoperative period and for rehabilitation if necessary. It is carried out if there is the involvement of muscles, fascia and fibre.
2. Amputation-removal of the breast without resection of the axillary tissue, is used either for urgent indications in severely weakened patients, or for initial forms of cancer in elderly patients for whom the aesthetic side of the operation is not relevant, and the operation itself has practically no serious complications.
3. The technique of mastectomy by Madden. During this organ-preserving operation, the axillary tissue is not removed so widely, the small and large pectoral muscles are preserved.
4. Mastectomy by Petty. It involves the removal of the pectoralis minor muscle, but the preservation of major.

What is the rehabilitation period like?

Rehabilitation includes correction of existing hormonal disorders, diet, vitamin therapy, psychotherapy. If restoring of the previous form of the mammary gland is necessary, plastic surgery is performed. At 7-10th day after the intervention, physical therapy begins. The complex of exercises is selected by the doctor. Ignoring gymnastics after a mastectomy can lead to a limited range of motion in the shoulder joint and disability.