In this operation an ellipse of skin is taken from around the cancer and the nipple. The incision used tends to be in line with the nipple and wherever the cancer is. So if the cancer is in the upper outer quadrant, as is usually the case, the skin ellipse is usually in an oblique direction from the armpit, aiming downwards towards the midline. But if the lump is to one or other side of the nipple, then the incision will be a transverse one.

If too much skin is removed, the skin that remains may die, and there is a risk that a skin graft will be required. Therefore, only as much skin as necessary is removed. The subcutaneous fat is kept in place to give a cosmetically acceptable scar, and to allow for the painless use of prosthesis in the bra later. It is uncertain whether or not leaving more skin to facilitate a later reconstruction of the breast is dangerous in terms of ensuring the removal of all cancerous tissue, but most surgeons will err on the cautious side in any cancer operation.

The whole breast is then removed, together with the tail of the breast which goes into the armpit, and its associated lymph nodes. If all the lymph nodes are excised, one of the chest wall muscles – the pectoralis minor – must be split or removed to allow good access to the armpit. Radiotherapy is not necessarily required, although there is controversy here. Some surgeons believe that if all the lymph nodes are removed from the armpit, radiotherapy is unnecessary and, indeed, that if it were given, there would be a risk of swelling of the arm post-operatively. Other surgeons believe that only sampling of the lowest-lymph nodes in the armpit is necessary. If the nodes are found not to be involved, then it is clear that the cancer is probably confined to the breast and radiotherapy is therefore unnecessary. If, however, the nodes are involved, radiotherapy is indicated. The decision between these two types of treatment is a difficult one, both for the patient and the surgeon, and needs to be discussed carefully.

*39/39/5*

Random Posts

• SYMPHOSAN – A TRIED AND TESTED REMEDY (CONCLUSION)
• THE ROLE OF FAT IN ENERGY BALANCE: IMPLICATIONS
• HUMAN IMMUNODEFICIENCY VIRUS INFECTION – CLINICAL MANIFESTATIONS (GROUP I)
• HOW TO BECOME A BETTER LOVER – BODY
• ANXIETY DISORDERS/WORKING THROUGH THE RECOVERY: HOW MUCH WE NEED TO PRACTISE A CBT PROGRAM
• BABY AND CHILDHOOD RESPIRATORY DISORDERS: PLEURISY
• DRUG FOR ERECTION: YOHIMBINE AND IT’S SIDE EFFECTS
• HERNIAS (RUPTURES)
• BABY AND CHILDHOOD ILLNESSES: AGGRESSIVE BEHAVIOUR
• FOR SOCIAL WORKERS, TEACHERS, EMPLOYERS AND MEMBERS OF THE HELPING PROFESSIONS: HELPING THE DRUG-USING ADDICT OR THE DRINKING ALCOHOLIC-PRISON, THE LAW AND ADDICTION