Segmental Mastectomy

• Segmental Mastectomy is a breast-conserving surgery for early-stage breast cancer.
• It involves removing the tumor and a surrounding margin of healthy tissue.
• The segmental mastectomy procedure typically includes anesthesia, incision, tissue removal, and closure.
• Segmental mastectomy recovery involves managing pain, limiting activity, and attending follow-up appointments.
• It differs from lumpectomy mainly in the amount of breast tissue removed, with segmental mastectomy typically removing a larger segment.

What is Segmental Mastectomy?

Segmental Mastectomy refers to a surgical intervention for breast cancer that involves excising the cancerous tumor along with a significant portion of healthy breast tissue surrounding it. This procedure is a form of breast-conserving surgery, also known as partial mastectomy or quadrantectomy, where the goal is to remove all cancerous cells while preserving the majority of the breast. It is typically recommended for patients with early-stage breast cancer where the tumor is localized and can be effectively removed with clear margins.

The extent of tissue removed in a segmental mastectomy is greater than that in a standard lumpectomy but less than a total mastectomy. The removed segment usually includes the tumor, a margin of normal tissue, and sometimes the overlying skin and underlying chest wall lining, depending on the tumor’s location and size. This approach aims to achieve local control of the cancer while maintaining a more natural breast appearance compared to a complete mastectomy.

Segmental Mastectomy Procedure and Recovery

The segmental mastectomy procedure typically begins with the administration of general anesthesia. Once the patient is asleep, the surgeon makes an incision in the breast, carefully removing the tumor along with a surrounding margin of healthy tissue. In some cases, a sentinel lymph node biopsy or axillary lymph node dissection may be performed concurrently to check for cancer spread to the lymph nodes in the armpit. After the cancerous tissue is removed, the remaining breast tissue is often reshaped to achieve the best possible cosmetic outcome, and the incision is closed with sutures.

Segmental mastectomy recovery usually involves a hospital stay of one day, though some procedures may be outpatient. Patients can expect some pain, swelling, and bruising in the breast area, which can be managed with prescribed pain medication. Activity restrictions are common in the initial weeks, including avoiding heavy lifting and strenuous exercise, to allow the surgical site to heal properly. Drainage tubes may be placed temporarily to remove fluid buildup. Follow-up appointments are crucial to monitor healing, discuss pathology results, and plan for any subsequent treatments like radiation therapy, which is often recommended after breast-conserving surgery to reduce the risk of recurrence.

• Pain Management: Over-the-counter or prescription pain relievers as directed.
• Activity Restrictions: Avoid heavy lifting and strenuous activities for several weeks.
• Wound Care: Keep the incision site clean and dry; follow specific dressing instructions.
• Monitoring: Watch for signs of infection such as increased redness, swelling, warmth, or pus.
• Follow-up: Attend all scheduled appointments for wound checks and further treatment planning.

Segmental Mastectomy vs. Lumpectomy: Key Differences

While both segmental mastectomy and lumpectomy are forms of breast-conserving surgery, they differ primarily in the amount of breast tissue removed. A lumpectomy, also known as a wide local excision, involves removing only the tumor and a small margin of healthy tissue around it. Segmental mastectomy, on the other hand, removes a larger segment or “quadrant” of the breast, which includes the tumor and a more substantial amount of surrounding healthy tissue. This distinction can impact the cosmetic outcome and, in some cases, the need for further surgery to achieve clear margins.

The choice between these procedures depends on various factors, including the size and location of the tumor, the size of the breast, the patient’s preferences, and the surgeon’s assessment. Both procedures are often followed by radiation therapy to eliminate any remaining cancer cells and reduce the risk of recurrence. Understanding these differences is crucial for patients when discussing their treatment options with their healthcare team.