Breast Flashcards
What are the 4 types of breast procedures?
Mastectomy
Partial Mastectomy (Lumpectomy)
Reconstruction
Reduction (mammoplasty)
What two types of surgeon perform mastectomies?
General surgeons (with specialized training) and surgical oncologists
What type of surgeon performs reconstructions and reductions?
Plastic
What is a mastectomy?
Surgery to remove all breast tissue as a way to treat or prevent cancer
What are the 5 types of mastectomies?
Total Simple Modified Radical Radical Skin Sparing Mastectomy (SSM) Nipple Sparing Mastectomy (NSM)
What is a Total Simple Mastectomy?
Removal of the breast tissue, nipple, and areola with large skin incision
What is a Modified Radical Mastectomy?
Removal of the breast tissue, nipple, areola, and lymph node bundle in axilla or armpit
What is a Radical Mastectomy?
Removal of the breast tissue, nipple, areola, lymph node bundle in axilla or armpit, underlying muscle (minority of mastectomies)
What is a Skin Sparing Mastectomy?
removal of breast tissue, nipple, areola, with preservation of vast majority of overlying skin for cosmetic advantage during reconstruction
What is a Nipple Sparing Mastectomy?
newer technique performed when cancer is not near nipple or areola and is not of large size – incision is made on edge of breast or around edge of areola and breast is hollowed out, keeping nipple/areola complex intact
What are the risks of mastectomy?
pain, infection, bleeding, long term swelling or lymphedema of arm or breast, formation of hard scar tissue at surgical site, shoulder pain and stiffness, numbness under arm from nerve injury during lymph node removal, and hematoma
What is another name for Partial Masectomy/Lumpectomy?
Breast conserving or breast sparing surgery
What is the margin?
A small amount of normal tissue around the lump is taken to help ensure all of the cancer or other abnormal tissue is removed
What is Breast Reconstruction?
A surgery to rebuild chest mound after mastectomy so that it is the same size and shape as it was before - also, nipple and areola can be recreated
What are the three types of Breast Reconstruction?
Immediate (one stage), Delayed (two stage), Flap
What is an immediate reconstruction?
Implant is placed directly after the mastectomy by plastic surgeon on the same day under pectoralis or above it where breast tissue was removed (sometimes a graft or absorbable mesh to hold in place)
What is a Delayed Reconstruction?
Two stage - after mastectomy, a tissue expander similar to a balloon is placed under chest muscle to stretch space and skin above for permanent implant - it is filled over a 4-6 month period with saline over a valve. Carries lower risk of postoperative complications.
What are four types of flaps?
Tram Flap, LDM Flap, DIEP Flap, Gluteal Free Flap
What is a Tram Flap?
Transverse Rectus Abdominus Myocutaneous uses skin and subcutaneous tissue from the tummy
What is a DIEP Flap?
Deep Inferior - uses fat and skin from same area as TRAM flap but does not use muscle, just fat and skin
What is an LDM Flap?
Moves muscle and skin from upper back when extra tissue is needed
What is a Gluteal Free Flap?
Newer type that uses tissue from buttocks including gluteal muscle
What is a breast reduction?
Excess fat, glandular tissue, and skin are removed from breast - also called reduction mammoplasty
What are the three reasons a breast reduction is performed?
To address neck and back pain
Under breast rashing (intertrigo)
Cosmesis
