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Mastectomy Medicine Physiotherapy Surgery

Brief Note on Mastectomy

In this article we will discuss Brief Note on Mastectomy

In this article, we will discuss Brief Note on Mastectomy. So, let’s get started.

Mastectomy

Indications

• Benign breast masses
• Noninvasive breast tumours
• Invasive breast tumours (malignant)

Types of Mastectomy

• Lumpectomy or wedge resection or tylectomy or tumourectomy
• Radical halsted’s operation (axillary lymph nodes + Pectoralis major)
• Simple mastectomy
• Extended simple mastectomy (Patey’s) no PM involvement
• Quadrantectomy (tumour segment +axillary nodes)

Complications

• Bleeding from the surgical site
• Seroma – collection of fluid (lymph or serum) at the operative site
• Wound infection
• Possible skin slough a wound edges
• Thrombophlebitis of the axillary vein
• Numbness of the back of the upper arm usually due to sacrifice of a nerve to the skin (intercostal brachial cutaneous nerve).
• Weakness of the latissimus dorsi or serratus anterior muscles due to compromise of the thoracodorsal or long thoracic nerves, rare.
• Armoedema (swelling) is common but usually mild
• Limited range of motion of the shoulder. This occurs early after surgery, is limited and totally recoverable.

Management

• HRT (hormonal replacement therapy)
• Tamoxifen
• Chemotherapy
• Cyclophosphamide, methotrextate and 5-fluorouracil
• Breast reconstruction
• Silicone prosthesis
• Musculocutaneous Maps
• LD or TRAM lap

Physiotherapy

• Avoid early shoulder mobilization
• Adduction for 48 hours then 60 degree abduction
• Redivao drain used
• Oedoma management (elevation, compression, FUP & STM)
• If any brachial plexus injury, treat as LMN lesion
• Usual PT protocol

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