- Excision of mammary gland(s).
UsesSurgical treatment of mammary neoplasia
- Local excision :
- Shelling out tumor from gland.
- Suitable for small pea size nodules (less than 2 cm).
- Simple mastectomy :
- Tumor removal with associated gland.
- Partial radical mastectomy :
- → Removal of tumor with glands associated by vascular/lymphatic drainage and node.
- Radical mastectomy :
- → Removal of tumor with all ipsilateral glands and nodes.
- Bilateral radical mastectomy :
- Removal of all mammary tissue.
- Removal of large, ulcerated masses - more comfortable for patient.
- Early surgical intervention probably improves prognosis.
- Inflammatory carcinoma carries a very poor prognosis and dehiscence of the wound or recurrence/death occurs soon post-operatively - surgery not recommended.
- Standard surgical kit.
- Drains .
- Additional swabs as may bleed significantly.
- 15 min for large clip.
- Routine surgical preparation.
- Recurrence of neoplasia due to incomplete excision.
World Health Organization staging protocol
- Prognostic basis unproven.
- Prognostic markers controversial.
- Histopathological type: sarcoma greater than carcinoma greater than adenocarcinoma.
- Tumor volume.
- Rapid growth rate.
- Infiltration (abdominal muscle, skin).
- Distant metastasis.
- Lymphatic or vascular invasion.
- Regional lymph node enlargement/metastasis.
- Location of affected gland.
- Supraradical versus conservative surgery.
Reasons for treatment failure
- Tumor recurrence due to high malignancy or inadequate resection.