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>>>Dr. Harness: Mastectomy is the removal of the breast. Now, the good news with mastectomy
is that this is not your grandmother or great-grandmother’s mastectomy.
The mastectomies that we do in this day and age and can be done in ways that are cosmetically
so much better than what we did historically, and I think part of the history here is important
to review. In the late 1800s Halsted invented the radical
mastectomy, and frankly, I was involved with some of those even in my training in the 1970s,
where not only was the whole breast removed with the muscles and as much skin as we could
and all of the lymph nodes. It was absolutely horrible. And so when you mention the word
“mastectomy,” often people that kind of image jumps into their mind, because they
remember seeing how disfigured their grandmother was or whoever.
Fortunately then, we moved forward into what was called skin sparing mastectomies where
removing the *** areolar area, but saving all the skin, so that we can do reconstruction
and we will talk more about reconstruction later, but typical reconstruction is done
in two stages, first stage involves the placement of a tissue expander and then a second stage
involves a placement of a permanent implant. Now what I am pleased about is the emergence
now of *** sparing mastectomy. At breastcanceranswers.com I have got a description of eligibility for
***-sparing mastectomies and I will talk more about that in a subsequent video, but
the concept for the *** sparing mastectomy in selective cases is, we leave all of the
skin, we leave the *** areolar area, hopefully we can come in and an incision down here in
the inframammary fold below the breast and another one here in the axilla or the armpit
area, so that when the patient is reconstructed, these incisions are hidden and she is feeling
cosmetically really good about herself. Now one of the real misconceptions about mastectomy
is “oh gosh I have a big operation like a mastectomy, I am going to do better” not
true. The survival from breast cancer is the same whether a patient has a lumpectomy or
a mastectomy and there are certain times where we actually need to do a mastectomy and not
a lumpectomy and we can talk more about that subsequently, but the bigger the operation
does not mean Gee Dr. Harness I will not need chemotherapy or gee I will not need tamoxifen
or one of those other things. As I have said on the video about invasive
breast cancer, once we start shutting off cancer cells elsewhere in the body with any
stage of invasive breast cancer, we need to treat the whole body. So summarizing the mastectomy,
it is a removal of the breast. We are always then finding out what is going on with the
lymph nodes at the same time. It also can be done with reconstruction or actually without
reconstruction. Some patients choose not to be reconstructed and therefore we want the
skin down nice and flat, so its easier to wear prostheses in the bra, but please remember
that because this is usually being done for invasive cancer, sometime we do it for in
situ often then you do need additional therapies. *****
Hi, I am Dr. Jay Harness and I want to share with you an important information that I believe
that every newly diagnosed patient with breast cancer needs to know.
Susan Denver: “I am a breast cancer survivor.”
Katherine Stockton: “I am a breast cancer survivor.”
Coree: “I am a breast cancer survivor…”
Susan Denver: “…and I want every woman to know…”
Katherine Stockton: “…about personalized breast cancer treatment…”
Susan Denver: “…and the Genomic Test.”
Coree: “A test that helps guide a woman and her doctor…”
Katherine Stockton: “…to the best treatment options for her.”
Susan Denver: “Pass it on!”