Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
WHAT IS A Mastectomy?
Cancer arises from rapid cell mutation. This disease forms in breast cells and spreads to the breast ducts and lobules. Lobules secrete milk, and the ducts transport this milk from the glands to the nipple. Cancer is not only confined to the ducts and lobules but can spread to the breast’s fatty tissue. If left untreated, cancer cells can migrate to healthy breast tissue and eventually infiltrate lymph nodes situated under the arms. From there, cancer can quickly spread in the bloodstream throughout the body.
What are the signs of breast cancer?
Breast cancer can be difficult to detect in its initial stages as the tumours are usually too small and cannot be felt during a physical exam. A mammogram, however, can pick up a structural abnormality. You may notice signs of breast cancer that include:
- A lump under the breast
- Swollen regions of the breast
- Abnormal discharge from the nipple
- Bloody nipple discharge
- Flaky or scaly skin around the nipple
- Lump in the armpit
- Change in the appearance of your breasts
- Pain in the breast region
What are the different forms of breast cancer?
The different forms of breast cancer are either classified as "invasive" or "non-invasive." Invasive cancer travels and spreads from the lobules or ducts to other regions of the breast. Non-invasive cancer (also known as carcinoma-in-situ) does not spread from its original location. The common types of breast cancer include:
- Ductal and lobular carcinoma-in-situ
- Invasive lobular and ductal carcinoma
Rare forms of breast cancer include:
- Paget’s disease of the nipple: Paget’s disease is a rare form of cancer that develops and matures in the nipple ducts. The mature cancerous cells affect the areola and skin of the nipple.
- Phyllodes tumour: These tumours are often benign, but in some cases, can be malignant. Although these tumours are rare, they develop in the breast's connective tissue.
- Angiosarcoma: An angiosarcoma occurs in lymph and blood vessels within the breast.
Your symptoms could either be a sign of breast cancer or a benign condition. Dr Mitchell performs a physical exam as well as additional tests to confirm or rule out a diagnosis of breast cancer. Some of these tests include:
- A mammogram: The doctor orders a mammogram to examine tissues deep within the breast. Additional tests are needed once the test picks up abnormal regions of the breast.
- A breast ultrasound or MRI: Tests such as an ultrasound or MRI capture images of the breast tissue. Once Dr Mitchell analyses the results from the ultrasound or MRI, she can differentiate between a tumour and a cyst.
- Breast biopsy: When indicated, the breast surgeon will carry out a breast biopsy to check for cancer.
There are several surgical procedures aimed to treat breast cancer. Dr Mitchell performs a subcutaneous mastectomy to remove breast tissue but preserves the nipple region. The breast remains flat after the breast surgery but can then be reconstructed with surgical breast implants.
After the procedure, you will receive instructions on how to clean and preserve the surgical area. You may feel pain after the surgery, but the breast surgeon will prescribe medication to relieve breast pain.
It’s important to practise exercises as instructed by the doctor to warm up your arm and shoulder area. Usually, after a lymph node dissection, there’s a considerable amount of pain. Pain after the procedure causes the shoulder and arm to remain stiff.
After breast surgery, however, you must avoid strenuous exercise, particularly activities that involve the arm, especially activities such as vacuuming, washing windows and driving.
Contact Dr Mitchell if you notice signs that include:
- Pain near the incision
- A tingling sensation of the arm
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr Mitchell is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr Mitchell takes no responsibility for any errors or omissions present on this website and is not liable for any consequences that may occur from misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.