Mastectomy
1. Total (simple) mastectomy: � Alongwiththetumour,entirebreast,areola,nipple,skin over the breast, including axillary tail are removed. There is no axillary dissection. Often the patient is subjected toradiotherapylater(External)toaxilla.Pectoralfascia is removed along with breast specimen; breast tissue superficial to axillary fascia is removed. 2. Total mastectomy with axillary clearance: � Commonly used procedure. Total mastectomy is done along with removal of axillary fat, fascia and lymph nodes. Level I and II axillary nodes are removed along with total/simple mastectomy. Mastectomy specimen should be carefully inspected and sent to pathology department x Specimen is sent in formalin for histology. x It is sent in saline in low temperature for ER/PR/Her 2 neu status study (histochemistry). x Specimen mammography is often done. x Tumour grading, tumour clearance, nodal involvement—its number and capsular breach are assessed histopathologically. x Halsted Radical Mastectomy* (Complete Halsted) (RM): Structures removed are: � Tumour. � Entirebreast,nipple,areola,skinoverthetumourwithmargin. � Pectoralis major and minor muscles. � Fat, fascia, lymph nodes of axilla. � Few digitations of serratus anterior.
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