In what cases the breast is removed completely. Removal of the mammary gland postoperative period. Is there a difference in the aesthetic effect after breast reconstruction due to lumpectomy and complete reconstruction after radical resection?

Breast pathologies are found in both women and men. Most of them pose a threat to health and require mandatory medical intervention. When conservative treatment of diseases is ineffective or impossible, surgical treatment is performed - a mastectomy. What it is, in what cases it is prescribed and what you need to know about the postoperative period, we will find out further.

What it is

A mastectomy is a surgical operation to remove the breast. Together with it, adjacent lymph nodes and subcutaneous fatty tissue are excised. Depending on the type of intervention, the small and/or large pectoral muscles are also removed.

The purpose of the operation is to prevent the spread of pathological processes in the mammary gland.

This is a serious traumatic procedure associated with risks and possible postoperative complications, but for some breast diseases, only a mastectomy performed gives a chance for life.

Indications for mastectomy

Radical intervention in the treatment of diseases of the mammary glands is carried out mainly in women (97% of all cases) and is prescribed:

in the presence of ;
at ;
with multiple;
at ;
with its complications (phlegmonous or gangrenous forms);
to prevent the development of breast cancer, if the patient is at risk for a genetic predisposition.

Mastectomy is less commonly performed in boys and men. An indication for its appointment is gynecomastia - an increase in the mammary glands associated with hormonal disorders in the body.

Types of Surgery

Even in the recent past, mastectomy was performed in one standard way - radically according to Halsted-Meyer. During the operation, the affected mammary gland was completely removed along with the muscles, lymph nodes and subcutaneous fat located in the axillary, subclavian and subscapular regions.

Advances in surgery have expanded the possibilities of surgical intervention in the treatment of breast diseases - more gentle (but no less effective) solutions have been found.

Currently, several types of mastectomy are used:

partial;
radical (classical and modified);
preventive.

The choice of intervention depends on the stage and degree of breast pathology, as well as on the age and general health of the woman.

Partial mastectomy

With a partial mastectomy, only the part of the breast where the tumor is found is removed. Such an operation is possible at an early stage of cancer, with purulent forms of mastitis, fibrocystic mastopathy.

In cancer, a course of radiation therapy is mandatory to prevent further spread of malignant cells. After the operation, constant monitoring of the condition of the breast is necessary, and in case of recurrence, a radical removal of the gland is indicated.

Radical mastectomy

The classic version of the radical mastectomy (according to Halsted) is still used today. The operation is performed in the following cases:

involvement in the process of spreading the tumor cells of the pectoralis major muscle;
metastasis to lymph nodes located on the posterior surface of the muscle;
in palliative medicine to alleviate the patient's condition.

The method often leads to postoperative complications, especially the limitation in the mobility of the shoulder joint.

If a woman does not have indications for a classic radical mastectomy, the choice is made in favor of more gentle modified intervention options:

according to the Patty-Dyson method with the removal of the mammary gland, lymph nodes, adjacent tissues and pectoralis minor muscle;
according to the Madden method, in which both chest muscles are preserved.

Operations are accompanied by significantly less blood loss and faster healing of sutures. The main advantage is the reduction of postoperative complications.

Prophylactic mastectomy

Mastectomy to prevent the onset or development of breast cancer is prescribed for women with a genetic predisposition to the disease (if a BRCA gene mutation was detected in the tests) or for those who already had cancer of one breast.

The intervention is carried out both radical and partial with preservation of the nipple and areola of the breast. It can be one-sided or two-sided. During a mastectomy, it is possible to simultaneously reconstruct the mammary glands.

Analyzes and preparation for surgery

Mastectomy is prescribed only if the relevant diagnoses are confirmed after laboratory tests, analyzes and hardware examinations of the patient.

Before the operation is assigned:

general and clinical analysis of blood;
x-rays of the breast and armpits (mammography, axillography);
Magnetic resonance imaging;
breast biopsy.

The preparation before surgery also includes the passage of an ECG, fluorography. A personal examination of the patient by a specialist is required. The doctor must be informed of the following:

about taking all medications or dietary supplements, even if they are herbal tinctures or vitamin complexes;
about existing chronic diseases and previous serious illnesses;
about a possible allergic reaction to drugs or general anesthesia.

In the presence of inflammatory processes in the body, 2 weeks before surgery, the patient should undergo a course of antibiotic therapy.

One week before a mastectomy, if you use blood thinners, you must stop taking them.

Before the operation, you can not eat (12-16 hours) and drink (2-4 hours), it is recommended to do a cleansing enema the night before.

In addition, it is necessary to take care of who will pick up from the hospital and take care of postoperative care.

Risks associated with a mastectomy

Like any other surgical intervention, a mastectomy is associated with risks and possible complications during the procedure:

risk of pulmonary embolism (formation and detachment of a blood clot);
breathing problems;
allergy to anesthesia or medications;
bleeding and blood loss;
heart attack.

Complications can be prevented if you first warn the doctor about allergic reactions and past illnesses and carefully follow the recommendations for preoperative preparation.

How is the operation performed

Mastectomy is performed under general anesthesia, the duration is 2-3 hours, depending on the type of intervention. The operation time will increase if reconstructive surgery is performed at the same time.

The surgeon makes an oval incision under the breast with a scalpel from the inside at the sternum to the armpit, 12-16 cm long. The breast tissue is removed along with the subcutaneous tissue, subclavian, subscapular and axillary lymph nodes, if necessary with the pectoral muscles.

Then the incision is sutured, absorbable sutures or staples are applied, which are removed by the doctor after 12-14 days. To remove excess fluid and accelerate wound healing, drainage is installed under the skin of the chest - one or two plastic tubes.

At the end of the operation, the woman is transported to the ward, where she is under the close supervision of medical personnel for the first 36-48 hours.

Postoperative period

Mastectomy is one of the most complex surgical interventions. The postoperative recovery period lasts 2-3 months. Within the walls of the medical institution, you will have to spend no more than 4 days, if it was done - about a week. During the first month, you will have to regularly visit the hospital for dressings and examination.

The next day after the operation, you can get up and start walking slowly. It is recommended to start rehabilitation measures as soon as possible, which will be prescribed by the doctor. This will prevent the risk of complications and speed up recovery.

Immediately after recovering from anesthesia and for the next 3-4 days, intense pain in the chest area will be felt. To reduce their severity, the doctor will prescribe painkillers.

Discharged home with drainage tubes, they are removed after 5-7 days during the follow-up examination. The nurse should teach you how to handle the drain and tell you about the rules for maintaining body hygiene without damaging the dressings and the drain.

Consequences of a mastectomy

After the removal of the mammary gland, a woman has an extensive wound surface in the chest area, which requires proper care. Such an intervention rarely goes unnoticed for the physical and psychological health of a woman.

Experts identify several of the most common consequences of a mastectomy.

early and late complications;
relapses of diseases;
psychological trauma associated with loss of attractiveness, disability.

Knowing about the possible consequences of the operation and how to overcome them in advance, you can avoid panic and deal with them more easily.

Complications after mastectomy

Despite the fact that the methods of surgical intervention are constantly being improved, the number of various complications remains high.

Patients most at risk:

the elderly (over 60 years old);
with overweight;
with chronic diseases (cardiovascular system, diabetes, hypertension);
having large breasts (from the 4th);
after radiation or chemotherapy.

Preoperative preparation of this group of patients should be carried out even more carefully, and rehabilitation procedures - more carefully.

Allocate early and late postoperative complications. Early (arising within the first 3-4 days) include:

bleeding due to poor blood clotting, divergence of seams;
leakage of lymph (lymphorrhea);
marginal necrosis with divergence of sutures;
infection and suppuration of the wound surface (occurs when aseptic and antiseptic rules are violated during surgery or during the dressing process).

In addition to early complications, women often experience long-term consequences of a mastectomy:

violation of the outflow of lymph from the hand, which leads to stagnation of the lymphoid fluid and a strong increase in the limb in volume (lymphostasis);
violation of venous circulation due to damage to the subclavian or axillary veins;
erysipelas provoked by lymphostasis and the addition of streptococcal infection;
the appearance of keloid scars that cause pain when moving;
swelling of the shoulder area, loss of skin sensitivity;
limited mobility of the upper limb;
phantom chest pains.

Prevention of the development of complications and the duration of the recovery period after surgery largely depends on the qualifications of the surgeon and on the patient herself.

Relapses after mastectomy

Even after a successful operation to remove the mammary gland, relapses of cancer sometimes occur. They occur 6-12 months after surgery and are more aggressive and more difficult than the first time.

The reasons for relapses are:

insufficient diagnosis (during the examination, it was not possible to identify individual malignant cells, so they were not removed);
operations performed in the later stages of the disease;
metastasis to regional lymph nodes;
lack of radiation or chemotherapy after mastectomy;
poorly differentiated form of the tumor.

If within five years after the operation no relapses of the disease were detected, the cancer is considered defeated.

Psychological trauma

For some women, the most serious complication after a mastectomy is depression associated with the realization that they have become sexually unattractive, inferior, flawed. Also, stress can be caused by a forced change in lifestyle, which occurs in the postoperative period due to the weakening of the body and the inability to perform the usual household chores and work.

In overcoming psychological trauma, the support of family and relatives, friends, and attending physicians is important. In severe cases, it is recommended to seek help from specialist psychotherapists. In order not to complete due to the lack of a breast, it is necessary to purchase special corrective underwear or resolve the issue of breast reconstruction.

Problems with stitches after mastectomy

Slow healing of postoperative wounds (inflammation of the sutures, pain) is a problem that half of women face after a mastectomy for cancer. This is due to the inhibition of metabolism in cancer. The situation is complicated by postoperative treatment with the use of drugs that inhibit or completely suppress cell division (chemotherapy).

To heal the sutures, it is necessary to treat them with antiseptic, anti-inflammatory and wound healing ointments:

Baneocin;
Solcoseryl;
Stellanin;
Methyluracil;
Eplan;
Vulnazan.

Compliance with the rules of hygiene and treatment regimen will contribute to the speedy tightening of the seams.

Lymphostasis and swelling of the hand

Stagnation of lymphatic fluid in the arm (lymphostasis) after a mastectomy occurs as a result of the removal of lymph nodes during the operation, as a result of which the lymph circulation is disturbed. In this case, there is swelling and pain in the limb, a decrease in muscle tone. The hand can increase in size several times compared to a healthy one.

To eliminate lymphostasis, a whole range of measures is used:

massage and self-massage;
wearing a compression sleeve;
photodynamic therapy (using a monochromatic emitter);
taking medications (diuretics and venotonics);
metabolic therapy (use of natural antioxidants);
diet;
physiotherapy.

Swelling of the hand usually disappears a month after the onset of the pathology, but can persist for several years without responding to treatment.

Contraindications after surgery

A complex of rehabilitation measures helps to avoid postoperative complications and shorten the recovery time. But the success of rehabilitation therapy is greatly influenced by the implementation of the doctor's recommendations on the rules of behavior and regimen after mastectomy.

It is necessary to avoid crowded places, injuries. Due to disruption of the lymphoid system and weak immunity, any infection or scratch can lead to serious health consequences.
Within three years after the operation, you can not lift more than 1 kg with your hand from the side of the removed breast, more than 3 kg with the other.
Do not raise your arms, bend low, mop floors or hand wash.
The first three months should refrain from sexual activity.
You can not visit baths or saunas, take hot baths.
If the operation was performed to remove a cancerous tumor, it is not recommended to become pregnant for 2-3 years - hormonal changes in the body can lead to a relapse of the disease.
Within three years it is not recommended to change the climatic zone of residence, go on vacation to hot countries.
Smoked meats and canned food should not be present in the diet. It is best to switch to a salt-free diet.
You can not smoke and drink alcohol.

It is impossible to do without the help of relatives and friends in the postoperative period. Relatives should take over all the housework (gardening) to ensure that the mastectomy patient has the conditions for a speedy recovery. The care of relatives and the common sense of the woman herself are the key to a full recovery in a short time.

How to hide stitches after mastectomy

After removal of the mammary gland, any woman experiences discomfort about the changed appearance, is embarrassed by postoperative scars and scars. In this case, underwear for women who have undergone a mastectomy can help improve the psycho-emotional state. Its main task is to maintain the exoprosthesis of the mammary gland and mask the sutures.

Corrective bra

After a mastectomy, it is recommended to use a bra with a special pocket for the exoprosthesis. It can be worn immediately after the drainage is removed. The special design of underwear does not cause discomfort while wearing and contributes to an even distribution of the load on the spine.

Swimwear after mastectomy

To hide the seams and lack of breasts, you can purchase a corrective swimsuit. It is convenient to do physiotherapy exercises in the pool, hydrokinesiotherapy or just go to the beach.

The swimsuit sits comfortably on the figure, has a pocket for the prosthesis, does not compress or squeeze the chest.

Before choosing special underwear, you should consult with your doctor about the type, size and shape, especially if breast reconstruction is planned.

Breast reconstruction after removal

After a mastectomy, women often resort to reconstructive surgery to restore the volume and shape of the breast - mammoplasty. The operation allows patients to return to a full life and has a positive effect on their psychological state.

Reconstruction is carried out according to different methods, the timing of the possible operation also varies. The choice of breast reconstruction method depends on the type of surgical intervention to remove the mammary gland, the presence of postoperative complications and the wishes of the woman herself. One-stage mammoplasty is possible with subcutaneous and prophylactic mastectomy. After a radical removal of the mammary gland, it is necessary to wait 8-12 months to restore the previous shape.

Modern plastic surgery offers several methods of breast reconstruction.

Endoprosthesis method. Involves the placement of silicone or saline prostheses in the space between the muscles and the chest. To perform this type of breast reconstruction, a sufficient amount of own tissue is needed at the site of the removed breast. Most often, it is used after a subcutaneous mastectomy or according to the Madden method and is carried out in several stages.
Thoracodorsal transplantation. This method is suitable for breast reconstruction after radical mastectomy. It is based on cutting off a section of one's own skin and adipose tissue from the abdomen, back or buttocks and sewing it to the area of the mammary gland.
Reconstruction with a pedunculated SEIA flap. The latest achievement in plastic surgery. To form the future breast, abdominoplasty is performed (excess fat is cut off from the abdomen along with the skin) and a blood vessel is isolated, which is pulled inside the abdomen and then sutured into the thoracic artery. Thanks to this, the flap takes root well, and the new breast will feel as warm to the touch as your own. Over time, it is even possible to restore the sensitivity of the skin.

Each method has its own nuances and contraindications, so the choice of reconstructive surgery should be entrusted to a qualified specialist. It is recommended to consult several plastic surgery clinics and choose the best option for yourself.

A mastectomy should not be taken by a woman as a life tragedy. Successfully carried out postoperative rehabilitation and subsequent mammoplasty will become the basis for starting a new full life.

The operation of a mastectomy (removal of the mammary gland) for a considerable number of women is not a bad dream, but a reality. Such an intervention saves lives, but deprives the feeling of completeness.

It is very important for a woman to undergo an examination on time. With the advent of mammography (Rh-graphy of the mammary glands), it is much easier to detect breast cancer in the initial stage. After all, a mammograph is the device that “sees” and shows oncological foci ranging in size from 2-5 mm. It is not possible for a doctor to find such tiny tumors by palpation (hands).

After operation…

A woman can count on plastic reconstruction (restoration) of the breast. It is carried out in the oncological department of reconstructive surgery of the Research Institute of Oncology and Medical Radiology named after A.I. N.N. Aleksandrova, in the Department of Plastic and Reconstructive Microsurgery of the Minsk Regional Clinical Hospital. Also, this direction is being developed by the oncosurgical department N1 of the Minsk City Clinical Oncological Dispensary and a number of regional oncological dispensaries.

There are several reconstruction options:

endoprosthetics - implantation of a silicone prosthesis;
breast reconstruction using the patient's own tissues;
combined methods.

Where to find support?

How to find strength in yourself, regain confidence after a mastectomy? Here are the advice of a counseling psychologist Elena Nikolaevna Ermakova:

It is no secret that society dictates harsh conditions: a woman is a person when she is healthy, young, and beautiful. What about women who have undergone such a psychologically difficult operation as a mastectomy?

Change the dominant and discard stereotypes: now the most valuable thing is your life. She matters the most! And no matter what happens, parents and children continue to love you.

Those people who are most afraid of losing you, who need you no matter how you look ...

In addition, now it is important to find other women who have undergone the same operation in order to feel support, to feel: you are not alone! The consolations of healthy people are significant, but even more significant is the friendly word of those who have experienced and know firsthand about your illness and its consequences.

Of course, during this period, the support of a husband or friend is needed ... When the relationship of two people was originally built on love and mutual affection, then, as a rule, an illness or other serious condition only unites them.

In this regard, advice to men: do not pretend that “nothing like that” happened to your wife. Some husbands act this way for the best of reasons. But such a reaction sometimes deeply hurts a woman. Therefore, it is better to talk about what worries your half, only very delicately.

Listen to all complaints, fears, concerns. Just listen and let it speak. Set your wife to positive, talk about your feelings, because now more than ever, comfort and attention are important for her.

Sometimes it seems to a man in such a situation: some action on his part is enough - after all, he didn’t quit, he didn’t leave. What else does?! But for a woman in this state, this is not enough. The most important thing now is to provide the wife with maximum psychological comfort. Therefore, show more care, warmth, support not only with deeds, but also with words in full "volume".

A PHOTO Getty Images

Two years ago, Angelina Jolie shocked the whole world: in order not to get cancer, like her mother, she underwent a preventive double mastectomy - she removed both breasts. The surgeons, of course, restored the ideal figure of the actress with the help of plastic surgery. The desire to have a breast augmentation is the first thought that comes to mind after the operation. But can plastic surgery bring back the old life? Olga, 46, says no. “When I was in the hospital with bandages on my already flat chest, I had no doubts - of course, plastic. How is it, at forty years old and without breasts? But I endured the plastic surgery to restore the breast even harder than its removal. A prosthesis cannot replace an amputated arm. Implants will not replace breasts: a part of me, my body... After all, I breastfed my children! The operation will not bring back the old days, it will not help to “forget everything”. Artificial roundness can deceive others, but not yourself.

According to the Curie Institute in France, out of 12,000 mastectomy patients annually, only 20% agree to a follow-up operation. But why do so few women decide to take this step, if the thought of plastic surgery is the first thing that comes to mind? Psychoanalyst Françoise Brullmann is sure that, having learned about the upcoming mastectomy, women cling to the possibility of a future plastic surgery to restore the breast, hoping that it will become their salvation. Psychotherapist Carole Louvel, herself a breast cancer survivor, agrees. “Women are not to blame. To come to terms with the absence of breasts is difficult, impossible. But the majority then refuse plastic surgery, because they believe that they have endured enough due to the disease, their bodies are already crippled and isn’t it time to leave them alone? .. And some want to tell the world: “Yes, now I am like that, without breasts cut and sewn up. Accept me for who I am." And that's a very powerful message."

57-year-old Daria decided not to restore her breasts after the operation (both mammary glands were removed). “I love beautiful lingerie, I always had a large selection of lace and silk sets in my closet ... Therefore, at first I was sure that I would do breast augmentation. At first I wore special bra inserts, but one day I asked - why am I doing this? Why? Is it really just so that they don’t look at me as a sick person? And I realized that I do not want to depend on other people's views. This is my story, these are my scars. It happened to me and there's no point in hiding it. I threw away the tabs and started wearing light dresses and thin T-shirts... It's not easy: I want to warn all women - you will have to learn to endure the views of others. You will be looked at as a disabled person, with surprise, pain, shock. You will have to learn to speak - yes, I am different, but I am a woman, as before.

There is a direct connection between the word "femininity" and the diagnosis of "breast cancer". “The disease brings a woman back to the past. Involuntarily, questions about growing up, sexuality come up ... What were the views of those around you: lustful, admiring, mocking? says Françoise Brühlmann. Oksana, 52, burst into tears as her husband looked at and stroked her scar for a long time. “It was only then that I realized that I had not ceased to be a woman. My being was wounded, crippled, abused, both because of the removal of the breast and because of the chemotherapy. But it seemed to be waiting for the moment to be reborn. Accepting me for who I am (what I have become), my husband seemed to be telling me that I can be desirable - and for this I don’t need breasts ... This attitude is much more important than plastic surgery. Angelina Jolie once admitted that without the support of her husband, she would not have been able to survive a three-month cycle of operations: “Brad was present at each. Even in the most difficult moments, he managed to make me laugh.
“To decide whether or not to have a breast augmentation, a woman needs the support of her partner,” confirms Karol Louvel. How a woman feels about her loss depends in part on how her lover feels about it. Of course, true femininity is not limited to breasts or lack thereof.

40-year-old Svetlana resolutely refused lipofilling of 1 breast. “I didn’t even want to think about the fact that I would be cut off something on one side and attached to the other! Again operations, again suffer and endure? No, I can't and don't want to. I want the years of fear and sickness to be forever in the past. I want to enjoy life. And I also want my transformation to be beautiful, despite all those who are sure that life is over. Now Svetlana is thinking about creating beautiful lingerie for women like her.

And 42-year-old Valeria is looking for a good tattoo artist to turn her scar into a garland of delicate flowers. “This scar is a sign of the suffering I have endured. I want to learn to live with it, I don't need to erase it. You can’t erase a part of life, but you can force yourself to smile and enjoy even after the most terrible experiences.”

Having a breast augmentation means going back to life before the diagnosis. But those who have had a mastectomy say it's impossible. And today, thousands of women do not strive for this: their life goes on, no matter what.

1 The lipofilling technique allows the breast to be reconstructed by injecting fat taken from another area of the body.

Mastectomy is a surgical type operation associated with the removal (complete or sometimes partial) of the breast.

The very essence of this operation horrifies most women, and the idea that breast reconstruction after a mastectomy requires significant effort is also unlikely to add optimism to anyone.

However, often, this operation is almost the only right solution to save women from even greater health problems.

Note that the essence of the operation, which is commonly called a mastectomy, is:

Removal (complete or partial) of breast tissue in women (or rarely men).
Removal (full or partial) of the existing fatty tissue, which usually contains those lymph nodes that may be probable metastases.
Removal (full or partial) of both the small and large pectoral muscles of women, but this usually depends on the chosen option for the mastectomy itself.

Naturally, the postoperative period after such a surgical correction, the full recovery of women, can be quite long and difficult, not only physically, but also purely psychologically.

And all because most women after such an operation can experience significant pain, both physical and mental.

When is it necessary to remove the breast?

Quite often, a mastectomy may be required after detection in women (less often in men):

Cancers in the breast.
After confirming the diagnoses of nodular mastopathy, breast sarcoma.
Or after the development in women of some forms of purulent inflammation (mastitis) of the mammary gland.

It is extremely rare, but still mastectomy can be used for prophylactic purposes in women, with a proven by research, the genetic predisposition of a particular patient to the development of breast cancer problems.

Also, this operation can be performed purely for cosmetic purposes in men suffering from gynecomastia.

It should be noted that, as a rule, none of the women who are faced with the need for such an operation does not manage only with the removal of the mammary gland.

Today, most patients require a number of surgical actions that allow not only to remove the diseased mammary gland, but also to carry out its full restoration.

Plastic surgery (after breast removal), which is the restoration of the operated mammary gland, today is one of the most difficult, but at the same time, the most in demand.

At present, after performing a radical mastectomy (or its other variants), the so-called reconstructive operations are widely used. These are operations that are carried out using the patient's own tissues.

Of course, no less popular after the removal of the mammary gland is the so-called mammoplasty, which uses special endoprostheses, which is used in cases where there is not enough free tissue in the patient herself.

In general, we note that the recovery of patients facing a mastectomy is a process, although long and complex, nevertheless, quite familiar to modern physicians, and even perfectly debugged.

And this means that no matter how difficult and lengthy rehabilitation may seem to a woman, it is always a period that passes and is quickly forgotten.

Possible complications when removing the breast

Unfortunately, some patients who are faced with the need for an operation to remove the mammary gland may also face some complications of this treatment, both during the rehabilitation period and after it.

Naturally, these can be complications of a very different nature. So, for example, immediate complications of breast removal can include:

Varying severity of bleeding, which most often occurs in the earliest postoperative time period.
Dangerous suppuration of the postoperative wound site.
The so-called profuse lymphorrhea, etc.

Sometimes patients may also face the so-called long-term complications of the operation to remove the mammary gland. As a rule, these can be:

Conditions of lymphostasis, when the patient suffers from a violation of the full outflow of normal lymphatic fluid, which, accordingly, is accompanied by lymphatic edema of the arm from the side of the removed mammary gland.
Some mobility disorders directly in the shoulder joint, again, from the side of the removed mammary gland.

No less often, patients are faced with various kinds of psycho-sexual complications. Among such complications it is customary to name: postoperative depression, a feeling of inferiority or inferiority.

Sometimes such women limit social contacts on their own, and as a result, they begin to experience some difficulties in sexual life, which is completely unacceptable while maintaining normal sexual function.

And of course, it should be noted that most women who have undergone such a procedure remember the rehabilitation period as a time when certain pains are experienced. In this case, the degree of pain during removal of the mammary gland can vary from its moderate to severe manifestations.

How to get rid of pain after breast removal?

First of all, I would like to say that the rehabilitation process of patients with a removed mammary gland must necessarily be controlled.

It is categorically unacceptable to remain without medical support and assistance during the recovery period, it is the doctors who will be able to prescribe painkillers in a timely manner in case of severe pain syndrome, and correct the necessary treatment.

Often, such patients may be prescribed anti-inflammatory non-steroidal drugs, as well as ointments or balms, for local effects on the operated breast.

Sometimes in the postoperative period, patients require antibiotics, immunostimulants and even antidepressants. And this means that no matter how bad you feel, it is simply unacceptable to deliberately refuse medical assistance in this case.

The recovery process will go both easier and faster if the patient actively helps the doctors in this, accurately following all the instructions, and of course, having a positive attitude to the existing problems.

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Mastectomy - postoperative period

A mastectomy is a surgical procedure to remove the breast. Reasons for a mastectomy: breast cancer, breast sarcoma, or purulent formations.

A radical mastectomy involves the removal of the entire breast. Subcutaneous mastectomy involves the preservation of tissue reserves, the area of the nipple with the areola remains untouchable. Removal of the mammary gland is already a radical operation that causes maximum changes in the postoperative period.

Rehabilitation after subcutaneous mastectomy is much easier than with radical surgery. Recovery after a mastectomy should begin immediately after surgery.

Exercise after mastectomy

Therapeutic exercises after a mastectomy should be carried out in the presence of an instructor, and over time, a woman can do it on her own. If the work of the shoulder joint worsens, it is necessary to use rocking movements, raising and abducting the arm. The sore hand should be gradually involved in everyday movements: when combing hair, wiping with a towel, etc. For treatment, a gymnastic stick is useful. The goal of gymnastics should be aimed at restoring the mobility of the arm and improving the woman's well-being.

It is very important to do gymnastics regularly and gradually increase the load without sudden movements. When exercising after a mastectomy, it is not recommended to overdo it in the loads.

Complications after mastectomy

Complications after mastectomy to a greater extent can be associated with the tactics of antitumor treatment. Common complications after mastectomy:

blood clotting disorder;
phantom pains;
bleeding;
lymph outflow;
deterioration of the shoulder joint;
rachiocampsis;
neck pain;
slow healing of the wound site;
scar formation;
depressive states, etc.

Breast reconstruction after a mastectomy is a common occurrence. The breast can be restored both during the operation and after it. Most women refuse breast reconstruction or implants because there are a number of risks involved. Most often, women agree to the use of exoprostheses.

Nutrition after a mastectomy plays an important role. The diet should be changed, it is necessary to abandon fatty and refined foods and pay attention to vitamins.

Women should understand that life does not end after a mastectomy. Thanks to modern innovative technologies in the treatment and diagnosis of cancer, thousands of women maintain their health and return to a full life. It should be noted that the need for a mastectomy can occur in both women and men.

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Mastectomy is a life-saving operation. Postoperative rehabilitation

Postoperative rehabilitation after mastectomy

When the operation is over and there are no complications on the first day, the woman is transferred to the intensive care unit and literally the next day she must get up and begin a course of important postoperative rehabilitation measures. You should not feel sorry for yourself and become discouraged - this will greatly lengthen the recovery period. At this time, a woman should have a special primary underwear after a mastectomy, designed to secure a temporary textile exoprosthesis. This helps the wound to heal faster, does not allow to injure a fresh scar.

Usually, the mastectomy itself and the first days after the operation pass without complications, and the woman is allowed to go home for 2-3 days, right with drainage tubes in her chest. The medical staff will teach you how to maintain the drainage. After a subcutaneous mastectomy with breast reconstruction, hospitalization lasts longer - up to 5-6 days.

The first few days after breast removal are the most difficult and painful. You have to take painkillers, but only those prescribed by the doctor. After the 3rd day, the pain gradually disappears. Rise after the operation should be calm - do not make sudden movements, do not raise your arms above your head, you can not lift something heavy.

It will be necessary to go regularly for dressings and aspiration of the seroma formed under the skin after the removal of the drainage tubes - about 3-4 weeks. If the fluid accumulates and does not resolve, then it must be removed with an aspiration needle. During this period, based on the results of tests, biopsies and examinations, a further course of treatment is prescribed - chemotherapy, hormonal, radiation therapy or combined treatment. By the way, this complex therapy can be performed only with the consent of the patient. No one will force a woman to take chemotherapy drugs or radiation. Full physical recovery after mastectomy, in the absence of complications, is possible after one and a half to two months.

Now we will point out the most important difficulties that await a woman after a mastectomy operation, and in the course of therapy, and after the end of the course of treatment.

1) Oddly enough, the main problem for most women is not physical, but psychological - many have a period of depression. This greatly complicates the process of recovery, increases fatigue, reduces the body's defenses. It is extremely important not to let a woman become indifferent to her fate at this time, to support her. The support of family members is especially important. It also helps to communicate with women who have previously had a mastectomy, returned to a full life and now help others cope with this problem. For many women, the experiences they endured result in aggression towards the world and relatives, but this is natural. Any splashing of feelings, even negative ones, indicates that the woman is actively fighting for life and over time her condition will stabilize. It is much worse when the patient withdraws into herself, becomes indifferent to everything. In this case, it is necessary to communicate with a professional psychologist or psychotherapist. The period of psychological adaptation to a new state takes from 3 to 6-7 months.

2) It is imperative to allocate funds from the family budget for a high-quality exoprosthesis, buy underwear after a mastectomy, and everything so that a woman can compensate for the lack of breast volume as comfortably as possible.

3) A woman must independently learn how to care for a postoperative scar, take care of herself - for 3 years, do not lift more than 1 kg, do not do hard homework, especially in an inclined position - wash, wash floors, take care of the garden, etc. Especially it is important to adhere to this recommendation for women with lymphedema, that is, stagnation of lymph (lymphostasis) in the arm on the operated side.

4) Regarding work in the garden and garden - you should be very careful and you can only do it with gloves. The reason for this is that due to the difficult flow of lymph, the body cannot quickly and adequately respond to the ingress of pathogenic microbes into the smallest scratch or abrasion. And this, in turn, can provoke such an unpleasant disease as erysipelas. In general, at the slightest injury, it is imperative to immediately treat the wound with an antiseptic solution, at least with iodine or brilliant green.

5) We talked about the nutrition system after a mastectomy in a separate section - the rules are simple, everyone knows them anyway, but before the illness, few adhere to: do not overeat, bring weight back to normal, eat full, healthy, fresh food. It is necessary to abandon smoked meats, pickles, canned food. Limit sweets as much as possible. But that doesn’t mean that sometimes you can’t eat a piece of something tasty for pleasure. And of course - do not drink, do not smoke.

6) Of the other restrictions - you should refuse from the bath and sauna. Yes, and a foam bath is better to replace the shower. But swimming and physical education can be done some time after the wound has completely healed. A frequent question is whether it is possible to go to the sea and sunbathe. In fact, the first years after treatment, it is not recommended to change the climatic zone, so as not to provoke the return of the disease. But, in principle, you can go to the sea, you just can’t be in the open sun, but relax in the shade. Be sure to purchase special underwear for exoprostheses, as well as a special swimsuit for women with a silicone prosthesis, which can be either open or closed.

7) After undergoing oncology and mastectomy, it is categorically not recommended to become pregnant - this is due to a sharp hormonal change in the female body, which can become a provoking factor for the return of the disease.

8) In the first year after a mastectomy, you should visit your doctor at least once every three months, and in the next 5 years - every six months. Further visits to the doctor - once a year. At the same time, an oncologist should be constantly consulted if a woman receives any appointments from another specialist in the treatment of any disease - pharmaceuticals, physiotherapy, a course of immunomodulators, etc.

9) Concerning release from work. After a mastectomy operation, a sick leave is issued for a period of 10 days after the removal of sutures, if there are no complications, but with the possibility of extending it for another 30 days. If further treatment is prescribed, a sick leave is issued for the duration of treatment, but not more than 120 days. After that, the woman must go through the VTEC commission, which will decide whether to extend the sick leave or transfer the woman to a disability group.

10) The prognosis after mastectomy is favorable. Especially if the disease was detected in the early stages and adequate treatment was carried out. The 5-year survival rate for stage 1 cancer is more than 97%, for stage 2 cancer it is about 80-85%. It also depends on the type of cancer. Metastases in the first 5 years occur in 8-9% of patients. The same number of women have so-called latent (hidden or dormant) metastases, which can manifest themselves 10 or 10 years after the initial diagnosis and mastectomy. Metastasis occurs in the bloodstream - hematogenous metastases occur in the lungs, bones, kidneys, liver. If malignant cells spread through the lymphatic current, then metastases are possible in all lymph nodes.

In any case, the surgical removal of a breast tumor and the subsequent course of anti-cancer therapy allow a woman to maintain a full life for a long time. Without treatment, breast cancer develops rapidly and is fatal. The diagnosis of breast cancer today is the most positive in terms of survival. Especially when a woman is determined to fight the disease and return to a full life. Doctors will help to cope with a medical problem, relatives and psychologists will help with psychological experiences, and to make life more comfortable - high-quality breast exoprostheses and underwear after a mastectomy, which can be ordered on our website or purchased at the Valea chain of stores.

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Thank you for the article! I didn’t even know about the existence of such underwear, I’ll just buy it during the rehabilitation period.

Recovery after a mastectomy

A mastectomy is a surgical operation to partially or completely remove breast tissue affected by cancer. The patient needs a long recovery period after such an intervention. It usually lasts about two months for physical recovery and six months for psychological recovery.

Postoperative rehabilitation

If during the day after the mastectomy there are no complications, the patient is placed in the intensive care unit. The day following the operation, you can and should get up. The sooner a woman begins to perform rehabilitation measures, the less the risk of developing complications such as lymphostasis, erysipelas, and recovery will be faster. If rehabilitation is started late, then this process will stretch in time and will be more painful.

Those who underwent surgery almost immediately experience intense pain in the chest area. To reduce them, the attending physician must prescribe painkillers. It is recommended to use them moderately, preferably only with acute pain. Before this, an anamnesis is compiled with information about allergies and drug reactions. It is forbidden to drink alcohol and drive a vehicle during this time. Pain in the larynx may be present after general anesthesia.

At first, there may also be fever and a slight increase in body temperature, but such a reaction should not cause concern, this is quite normal during surgery, unless, of course, the negative symptoms increase and serious side effects such as erysipelas, lymphostasis, etc. .d.

Temporary side effects during removal of the mammary gland are edema and hematomas, to eliminate them, it is advised to use ice packs in the armpits and lymph node dissection areas. The incisions are sewn up with a special material, and covered with sterile dressings on top, so it is forbidden to correct and remove them yourself. The bandage is removed after a week, and the stitches - after two weeks, if they do not dissolve by that time.

A special drainage is installed for the woman to drain excess fluid, it is made of a plastic tube inserted subcutaneously on one side and a bag for taking it on the other. A day after the drainage is removed, the patient is allowed to take a shower. Care must be taken when wiping the area of the stitches, they should be gently blotted with a towel, avoiding the movement of sterile dressings.

Often, patients are concerned about the question of how many days they need to stay in the clinic after a mastectomy. As a rule, the operation and several days after it proceed without complications, and on the third day the patient is discharged from the hospital home without removing the drainage tubes. Health workers should be trained on how to properly handle the drainage system. In the case of subcutaneous mastectomy with breast reconstruction, the hospital stay is extended to six days to avoid implant rejection and erysipelas.

The pain begins to subside after the third day. A woman should get out of bed calmly, without sudden movements, avoid carrying heavy loads and not raise her arms above her head. It will take about four weeks to visit the clinic, make dressings and remove the serous fluid that forms after removing the drainage under the skin. Further, based on the testimony of tests and examinations, the doctor prescribes subsequent treatment. It could be:

chemotherapy;
therapy with hormonal drugs;
exposure;
combined treatment.

All procedures are carried out only with the consent of the patient, no one can force him to take chemistry or be irradiated. Return to the previous way of life occurs after about two months, if there are no complications.

Postoperative complications are determined by the volume of surgical intervention and are post-traumatic. The most typical are a shift in blood clotting indicators, erysipelas, lymphostasis. Phantom pains and asthenia are also characteristic. Since the patient has postoperative stress, wound healing may worsen and the period of lymphorrhea and scar formation may increase.

When diagnosing, the doctor relies on the patient's complaints, the nature of the pain and test results, as well as his own examination. The table below shows rehabilitation measures for various complications.

Table 1 - Complications and rehabilitation measures after mastectomy

exoprosthesis;
care instructions;
selection of special underwear.

pneumomassage, lymphatic drainage;
use of bandages;
photodynamic therapy;
physiotherapy;
hydrokinesitherapy;
metabolic therapy;
medical food.

physiotherapy;
hydrokinesitherapy;
wearing bandages for posture correction.

So, let's outline the difficulties that patients face after surgery to remove the mammary gland, as well as during and after treatment:

The most common problem is depression, which makes the whole process of recovery from cancer difficult. It aggravates the patient's condition, increasing fatigue and reducing the body's defenses. We need the support of relatives and communication with those who have already undergone these procedures and returned to a full life. In severe cases, it is recommended to contact psychotherapists so as not to delay the period of psychological adaptation.
After a mastectomy, it is imperative to purchase a good exoprosthesis, choose the right underwear so that the woman does not have a complex due to the lack of a mammary gland.
The patient needs to learn self-care of the scar in order to avoid its inflammation. Be careful with lifting weights, for three years you can not lift things that exceed 1 kilogram in weight. Limit housework, especially if it involves an inclined position. This is very important if there is stagnation of lymph in the arm from the side of the operation.
Be careful when working in the garden, do everything in seals to avoid introducing microbes into small wounds. In connection with the deterioration of the outflow of lymph, there is a threat of erysipelas. All cuts and scratches should be treated with antiseptics!
When removing breast cancer, it is not recommended to become pregnant, as a hormonal surge can provoke a recurrence of the disease. Proper nutrition plays a big role in recovery. The diet is simple and effective. Smoked meats and canned food are best excluded completely. Sweet with this diet is recommended to limit. In the diet, as much as possible, you need to increase the amount of vitamins, and reduce fats. Naturally, you can not smoke and drink alcohol. Main principles:
- do not overeat
- maintain normal weight
- eat fresh and healthy food.
Special exercises also help to recover. They need to be done while you are in the hospital. To develop a hand with gymnastics and massage to prevent lymphedema, you should start as early as possible, gradually increasing the load. In this, you need to be careful and do the exercises regularly. It is also important to monitor your posture, because the load on the spine changes.
Swimming and physical education have a beneficial effect on the convalescent body. And it is more rational to replace taking a bath with shower procedures. It is useful to swim in the sea, but it is forbidden to be in the sun. It is also important to know that a change in the climatic zone is unfavorable, as it can provoke a recurrence of breast cancer.
Constant observation by a doctor during the first year every 3 months, in the next five years - once every six months. It is necessary to consult an oncologist when prescribing treatment by other doctors, whether it is immunotherapy or physiotherapy.
Partial exemption from work or disability. Immediately after the operation, a ten-day sick leave is issued with an extension, if necessary, for another month. If there are complications, then it is issued for the entire period of treatment. But this period of time should not exceed 4 months. Some time after the mastectomy, the woman passes a medical commission that makes a conclusion on the need to prolong the sick leave, or the ITU, which assigns the patient a disability group. The mere fact of removal of the mammary gland is not a reason for obtaining a disability in the Russian Federation. It can be given temporarily to continue treatment, or permanently in case of a threat of metastases. In any case, the issue of granting a disability group is decided by a medical and social examination, to which the attending physician directs.

In general, the prognosis after mastectomy is quite favorable, especially in cases of early detection and competent treatment of breast cancer. Survival in the first stage of the disease is slightly less than 100%, in the second - up to 80%. It also affects the type of malignancy of the neoplasm. The appearance of serious complications (erysipelas, lymphostasis) causes more negative prognosis.

Timely removal of the tumor and a course of subsequent therapy can save a normal life for the patient for a long time. Without treatment, this disease progresses extremely quickly and leads to disability and death. Breast cancer today is one of the most positive in terms of survival prognosis. It is important to remember that life goes on after a mastectomy. A woman should tune in to a good outcome, this helps a lot in the fight against the disease.

Removal of the mammary gland postoperative period

Despite the confusion and depression after breast removal surgery, a woman, first of all, must understand that she needs to start the next chapter in life, let her body get used to the changes, it is especially important to try to avoid lymphatic edema or osteochondrosis. This will help easy exercises that need to be performed immediately after surgery.

Therapeutic gymnastics is recommended to restore arm mobility, correct posture and normalize general well-being. For the rehabilitation of the function of the hand, classes in the pool are also effective. When receiving treatment, the patient should be aware of possible complications and methods of prevention, thanks to which this can be avoided.

What to do in the early postoperative period

First of all, you need to understand that after surgery to remove the breast, all preventive measures must be taken comprehensively. So!

Do special exercises every day. Certain physical exercises improve muscle tone, lymph and blood flow, and joint mobility. They also reduce the likelihood of edema and inflammation.
To strengthen blood vessels, you need to take vitamins (as prescribed by a doctor).
Take care of your skin. It is necessary to regularly lubricate the skin of the hand on the side of the operation with special cosmetics - preferably plant-based.
Watch your hand. It will not be superfluous to write down the signs of edema, especially in case of rapid changes.

Get a special elastic sleeve at the pharmacy.
Do not load the sore arm with muscle work.
Do not allow the arm to be in a state of extension or flexion for a long time.
Massage regularly. It is especially effective in the early postoperative period.
Protect your hand from injuries, wounds, abrasions, bruises, insect bites. Since all this can become an additional focus of infections, due to which pathological processes can intensify in the area of edema.
Never measure blood pressure on the arm on the side of the breast removal operation. Also, you can not give injections and take blood tests.

The hand must be protected from direct sunlight.
Do not pinch your arm, that is, do not wear clothes with narrow and tight cuffs. The same applies to jewelry (rings, bracelets, watches, etc.).
When washing dishes and taking a bath, do not use too hot water. And it is better to replace the bath with a shower.

What to do in the late postoperative period - When to see a doctor

If, for any reason, you ignore the recommendations of a doctor regarding postoperative recovery, then you will definitely have problems in which you need to contact a doctor for help! So, when do you need to urgently see a doctor!?

If the hand becomes cold and/or too pale.
The edema becomes tighter and denser every day. Moreover, edema can be completely painless for quite a long time, but this does not mean its safety - you can miss the "precious" time.
If you begin to feel weakness in your arm, as well as stiffness in your elbow and / or shoulder joints.
If the swelling increases sharply.
If the swelling becomes "mosaic", that is, the arm swells in separate areas, and not completely.

IMPORTANT: “If you have venous insufficiency, then after surgery to remove the breast in order to prevent irreversible pathological changes in the soft tissues of the arm, you need regular medical and preventive examinations” - this is not even discussed, unless of course you want to return to normal / full life.

REMEMBER - a timely visit to a doctor will save your life! Diagnostics and consultations are carried out only at the doctor's appointment in the clinic. Remote diagnosis by phone or e-mail is not carried out.

Reception hours of doctors are from 10.00 to 17.00.

Saturday - from 10.00 to 13.00

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