Mastectomy 101

This surgical procedure is the most comprehensive of the breast surgeries. The most common type of mastectomy today is the MRM - modified radical mastectomy. This was my final surgery. You will be in the operating room, under sedation, for several hours. I stayed overnight in the hospital one night and returned home, heavily bandaged, with 2 drains attached, and a prescription for pain medication. Some women will have their sentinel node biopsy and or axillary dissection in conjunction with their mastectomy. I had my MRM alone, since I had already undergone the lymph node procedures during a previous surgery. For me, the worst part of the mastectomy was the time prior to the surgery. You are naturally concerned about losing a breast. Would I still be attractive? Was I right to decide that I didn't want reconstruction? How would I view my body after the surgery? How would my husband see me? What would my kids think? The night before my surgery was scheduled I decided that I wanted pictures of my chest the way it was. A roll of film later (without my face in the photos), I was content. The day of the surgery I was nervous, but not distraught. I admit that I did cry when they inserted the intravenous line in my arm prior to rolling me into the operating room. The tears were not from pain, but to acknowledge the loss of part of my body. The OR pre-operative procedure includes an IV line, a pulse oximeter, compression tubing on your legs, a blood pressure cuff on your arm. (None of these are painful, just part of the monitoring procedure) I awoke in my hospital room and felt OK! I looked down at my chest - couldn't see a thing - and felt well enough to grab my IV pole and wander to the bathroom. I had two drains attached and felt pretty darn good. I walked the hallways, ate normally and was really pleased that I was doing so well. Please remember, many women will have their MRM along with the lymph surgery. Check out the previous articles to see the side effects involved. The nurse arrived to change the bandages and asked me if I wanted to see the stitches. I declined. At home, it took me several days to look at the surgical site. I will not minimize the shock I had when I first looked at my chest. The scar looked red and angry and the skin was puffy and black and blue. The discomfort was almost non-existent. The scar now, after 18 months, is mostly faded to normal skintone and I am used to it. I am still me. I wear a prothesis most times, but often wander around home without it. (I was never big on wearing a bra anyway.) People who do not know me would never guess that I have a prothesis. Just as in some of the other breast surgeries, you will go home with a drain. A follow-up visit to your doctor will include checking the scar, removing stitches if they are not the dissolving type and plans to visit the oncologist for his opinion on any possible follow-up therapies. Generally, women who have no positive nodes and undergo a mastectomy will not have radiation. Today, there is a new type of "skin-saving" mastectomy, where the surgeon does not remove all the skin. Whether you are a candidate for this type of surgery depends on your staging, the location of your tumor(s), your surgeon's expertise and whether or not you will have reconstruction/chemotherapy/radiation. If you must have a mastectomy, I suggest you look at some pictures of women with mastectomy scars prior to your surgery. A visit to the plastic surgeon will confirm/negate your decision to do/not do reconstruction. The plastic surgeon can also show you many pictures of "before" and "after". If you are having a real emotional dilemna dealing with the loss of your breast, you can ask your surgeon for a referral to the social worker or you can contact http://www.y-me.org which has a 24 hour volunteer hotline. Some websites which will give you graphic details of a mastectomy are: http://www.susanlovemd.com/showme_frames...

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