Modified radical mastectomy

Modified Radical Mastectomy is a surgical procedure primarily used in the treatment of Breast Cancer. It involves the removal of the entire breast, including the Nipple, Areola, and most of the overlying skin, along with levels I and II of the underarm lymph nodes. Unlike a Radical Mastectomy, the pectoralis major muscle is preserved in a Modified Radical Mastectomy, which results in less disfigurement and a better functional outcome.

History

The Modified Radical Mastectomy was developed as a less invasive alternative to the Radical Mastectomy, which was the standard treatment for breast cancer from the late 19th century until the mid-20th century. The Radical Mastectomy, pioneered by surgeon William Stewart Halsted, involved the removal of the entire breast, pectoral muscles, and all axillary lymph nodes. However, it was associated with significant morbidity and disfigurement. The Modified Radical Mastectomy, which preserves the pectoralis major muscle, was developed to reduce these adverse effects while maintaining similar survival rates.

Procedure

The Modified Radical Mastectomy is performed under general Anesthesia. The surgeon makes an elliptical incision around the breast, removing the entire breast tissue along with the nipple and areola. The axillary lymph nodes are also removed through the same incision. The pectoralis major muscle, however, is left intact. The skin is then closed with sutures, and a drain is usually placed to prevent fluid accumulation.

Indications

The Modified Radical Mastectomy is indicated for patients with invasive breast cancer, particularly those with multiple or large tumors that are not amenable to breast-conserving surgery. It may also be performed for patients with extensive ductal carcinoma in situ (DCIS), inflammatory breast cancer, or recurrent breast cancer.

Complications

Potential complications of Modified Radical Mastectomy include Infection, Hematoma, Seroma, Lymphedema, and Pain. There may also be psychological effects due to the change in body image.

See Also

• Breast Cancer
• Mastectomy
• Radical Mastectomy
• Breast-conserving Surgery