Mastectomy Treatment Cost in India

All the breast tissue will be removed if a patient is diagnosed with breast cancer or is at a very high risk of developing it. One may have a unilateral mastectomy where only one of the breasts is removed or a bilateral one where both the breasts are removed together.

For various kinds of breast cancer, mastectomy is considered. The list and stages of breast cancer has been enlisted below:

• DCIS or ductal carcinoma in the site or noninvasive breast cancer
• Stages I and II (early stage) breast cancer
• Stage III (locally advanced) breast cancer- after sessions of chemotherapy
• Inflammatory breast cancer- after a chemotherapy session
• Paget’s disease of the breast
• Breast cancer that is locally recurrent

Along with a mastectomy, the surgeon can also recommend radiation if the following conditions are observed in the body:

• Two or more tumors are found in separate regions of the breast
• Widespread or malignant in appearance, calcium deposits found (can be microcalcification) all throughout the breast that has been found as cancerous after biopsy conducted on breast
• Radiation treatment was given to the patient previously in the breast region and the breast cancer recurred in the breast unfortunately
• The lady is pregnant, and radiation can create many unwanted risks to the unborn child in the womb
• Cancer is still found in the edges in spite of the patient having undergone a lumpectomy and risks of further spread of cancer still persists to other parts of the breast.
• The patient carries a mutation gene that puts her into high risk for developing second cancer in the breast again.
• The size of the tumor is relatively large compared to the overall size of the actual breast. Even after lumpectomy, the patient may not have too much healthy tissue left for achieving a cosmetic result that is acceptable.
• The patient suffers from a connective tissue disease such as scleroderma or lupus and may not be in a position to tolerate the side effects associated with radiation to the skin.

Apart from the above, mastectomy is considered even when the patient may not have breast cancer but is at high risk for developing the disease. A prophylactic or risk-reducing mastectomy usually comprises the removal of both the breasts and brings down the risk of developing breast cancer in the future significantly. When we say very high risk it indicates a strong family history of breast cancer or the presence of genetic mutations that have been carried out for generations in the family.

Mastectomy is a very broad term used to cover several techniques involved for removing one or more breasts. Aside from that, the surgeon may also remove nearby lymph nodes for the determination of the spread of cancer.

During an axillary node dissection, the surgeon removes quite a number of lymph nodes present in the armpit on the sides of the tumor.

In the sentinel lymph node biopsy, the surgeon removes only the initial few nodes which allow the tumors to drain which are called the sentinel nodes.

The lymph nodes that have been separated are then screened for cancer during the operation. If there is no sign of cancer then further lymph nodes will not be cut. But if cancer is detected the surgeon must delve deeply into other methods, such as radiation that is applied to the pole. When radiation therapy is required, then no more lymph nodes will be affected.

Removal of all tissue in the breast and most lymph nodes is called a modified radical mastectomy.

The more advanced mastectomy techniques remove lesser tissue and touch the least numbers of lymph nodes. Some of the other kinds of mastectomy are:

Total mastectomy: In a total mastectomy, also known as a simple mastectomy the entire breast is removed which includes the breast tissue, areola, and the nipple. A sentinel lymph node biopsy may be conducted during a total mastectomy.

Skin sparing mastectomy: In this case, just like the above all the components are removed but the breast skin is kept intact. A sentinel lymph node biopsy is also conducted simultaneously. Right after the procedure, breast reconstruction can be performed. But skin-sparing mastectomy may not be the solution for large-sized tumors.

Nipple-sparing mastectomy: A nipple or areola sparing mastectomy will comprise of removing the breast tissue which shall spare the skin, areola, and the nipple. A sentinel lymph node biopsy also has to be conducted along with and a breast reconstruction surgery which is done right after the surgery.

The surgical procedure is performed under general anesthesia, so the patient has no consciousness during the procedure. An elliptical incision is made around the breast by the surgeon. The tissues of the breasts are removed and depending on the above procedure and requirement other parts are thereby removed.

Irrespective of the type of mastectomy one may undergo the breast tissue and lymph nodes that are removed will be sent to a laboratory for further analysis. If the patient is also undergoing a breast reconstruction surgery, then the plastic surgeon will also coordinate with the breast surgeon to be present right at the time of the surgery.

Temporary tissue expanders are set as one of the breast reconstruction options in the chest. These temporary expanders to the chest will form the new breast mound. One of the options for women who will also need radiation therapy shortly after the procedure is to insert some topical tissue expanders in the chest to keep the breast skin in place. This will allow the final breast reconstruction to be delayed until completion of the radiation therapy.

If the patient is planning to have radiation therapy right after the surgery, then it is a good idea to meet with a radiation oncologist before the surgery for the discussion of benefits and risks and also to find out how radiation can impact the breast reconstruction options.

As the surgery is completed the incision is closed with the help of sutures which would either dissolve or get removed completely in the future. One or two small plastic tubes can be placed where the breast was removed. The tubes will finally drain all the fluids that accumulate after surgery. The tubes are kept in place by sewing the ends and a small drainage bag is attached at the end.

Instructions and restrictions shall be charted out before the patient to help them prepare for the surgery. Medications and vitamins or any supplement tablets taken by the patient must be discussed with the doctor.

Doctors may advise the patient to discontinue any blood-thinning medicine or aspirin type medication.

Just before the surgery one must not eat and drink (8 to 12 hours prior as indicated by the doctor).

Patients must be well aware of the time that she is required to stay in the hospital since if only one breast is removed then it may involve a one-night hospital stay while if it is both the breasts combined with reconstruction procedure then the stay time may be longer. If a sentinel node biopsy is done, then the region around the skin tumor right above the tumor is injected with a radioactive tracer and a blue dye. If this procedure is also performed, then the surgeon may recommend further stay, or the patient may be asked to come in advance.

After the surgery is over the patient is shifted to the recovery room for the proper monitoring of breathing, blood pressure, and pulse. The surgery site will be bandaged for several days and the patient will be instructed on how to take care of the region by keeping it dry and infection-free. In the underarm zone, it is common to feel some amount of numbness and pinching sensation. The patient can clearly understand from the doctor when it is suitable to wear a bra or breast prosthesis as required. Some pain medication and antibiotics are administered for pain and infection spread management.