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Friday 31 May 2013

Simple Mastectomy, Total Mastectomy and Modified Radical Mastectomy

What is Simple Mastectomy, Total Mastectomy and  Modified Radical Mastectomy for Carcinoma Breast?
Simple Mastectomy
Surgical removal of the whole of breast tissue superficial to  the pectoral fascia is called Simple Mastectomy. That means superficial fascia is left behind or not removed.
Total Mastectomy
Surgical removal of the whole of breast tissue including the pectoral fascia is called Total Mastectomy.
Modified Radical Mastectomy
Surgical removal of the whole of breast tissue including the pectoral fascia and level I, II and III axillary lymph nodes is called Modified Radical Mastectomy.
In other words Modified Radical Mastectomy is Total Mastectomy with Axillary clearance of lymph nodes.

Indication of Simple Mastectomy
Simple Mastectomy is done for Metastatic Breast Disease. It is also called Toilet Mastectomy. The purpose of doing Simple Mastectomy in Carcinoma Breast with metastasis is to prevent fungation and local ulceration of the tumor.
Indication of Total Mastectomy
Indication of Total Mastectomy is Paget Disease of the Breast with no palpable lump.
The treatment of Paget Disease of the Breast with a palpable lump is Modified Radical Mastectomy.
Indication of Modified Radical Mastectomy
Indication of Modified Radical Mastectomy is Early Breast Carcinoma and Paget Disease of the Breast with a palpable lump.
Different levels of Axillary Lymph Nodes
Axillary Lymph Nodes are broadly classified in to Level I, II and III nodes.
Level I axillary lymph nodes are the nodes located lateral to Pectoralis minor muscle.
Level II axillary lymph nodes are the nodes located beneath  or over the  Pectoralis minor muscle.
Level III axillary lymph nodes are the nodes located medial to Pectoralis minor muscle.
Types of Modified Radical Mastectomy
Patey’s Modified Radical Mastectomy :- Pectoralis  major muscle is  preserved and Pectoralis minor removed               
Scanlon’s Modified Radical Mastectomy :–   Pectoralis minor muscle is divided but not removed.             
Auchincloss’ Modified Radical Mastectomy :– Pectoralis minor is retraced but not divided.
Auchincloss’ Modified Radical Mastectomy is widely practiced nowadays.
Halstead’s Radical Mastectomy
In Halstead’s Radical Mastectomy both Pectoralis  major and Pectoralis minor muscles are removed along with the whole breast and the axillary lymph nodes.
What are the structures removed in Modified Radical Mastectomy (MRM)?
Whole of the breast tissue including the axilliary tail, along with the Tumor, Nipple Areola complex, Skin and the Level I, II and III Axillary lymph nodes are removed.

                                                 Images Courtesy: Madurai CME 2013


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13 comments:

  1. Unknown24 February 2016 at 18:21

    Greetings! I am a surgery resident from the philippines, and I was wondering what book or sources did you get the types of MRM (Scanlon, patey, auchincloss) from? I could not find it in Schwartz' or my book fo Current surgical therapy. Thank you

    ReplyDelete
    Replies
    1. Unknown9 August 2016 at 07:56

      Srb

      Delete
    2. Unknown9 August 2016 at 07:57

      Srb

      Delete
    3. Unknown27 September 2016 at 08:34

      http://onlinelibrary.wiley.com/doi/10.1002/1097-0142(197503)35:3%3C710::AID-CNCR2820350325%3E3.0.CO;2-9/pdf

      cheers!

      Delete
    4. Unknown8 February 2017 at 03:38

      check your mastery of surgery book

      Delete
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  2. Dr Basil6 June 2016 at 19:26

    Beautifully written . Thanks .

    ReplyDelete
  3. Skyhigh7 November 2016 at 08:59

    I think it was given in old bailey and love

    ReplyDelete
  4. Unknown19 January 2017 at 11:38

    Lovely... Precise

    ReplyDelete
  5. Unknown19 January 2017 at 11:39

    Lovely... Precise

    ReplyDelete
  6. Unknown16 March 2017 at 01:52

    Even in Sri RAM VHAT also mentioned these methods..

    ReplyDelete
  7. Unknown11 July 2018 at 09:44

    difference between mrm and mastectomy with axillary clearance...?
    u said both are equal...can u give the reference..?

    ReplyDelete
  8. varun18 January 2023 at 03:05

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    ReplyDelete

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