Answer
Indications for a simple mastectomy with a concomitant axillary procedure, which may be either a sentinel node biopsy or an axillary clearance, are as follows:
-
Locally advanced breast cancer
-
Multifocal breast cancer
-
Large tumor relative to the size of the breast, excision of which may compromise final cosmesis
-
Extensive ductal carcinoma in situ (DCIS)
-
Patient unsuitability for breast-conserving approaches as a result of contraindications for radiation therapy - Such contraindications include a previous history of chest wall irradiation, either after previous breast-conserving therapy or in mantle field radiation therapy for lymphoma; severe skin disorders, such as scleroderma and psoriasis; and severe pulmonary dysfunction
-
Patient preference for mastectomy - A patient who is a suitable candidate for breast conservation may opt for a mastectomy instead
-
Elliptical skin incision enclosing nipple-areola complex.
-
Superior flap being raised.
-
Raised superior flap, with breast being dissected off underlying pectoralis major.
-
Pectoralis major and serratus anterior visible at completion of mastectomy.
-
Postmastectomy scar.
-
Mastectomy scar 10 days after operation.
