Breast surgery is a form of
surgery
Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
performed on the
breast
The breasts are two prominences located on the upper ventral region of the torso among humans and other primates. Both sexes develop breasts from the same embryology, embryological tissues. The relative size and development of the breasts is ...
.
Types
Types include:
*
Breast augmentation
*
Breast reduction
*
Breast-conserving surgery, a less radical cancer surgery than mastectomy
*
Lumpectomy
*
Mastectomy
*
Mastopexy, or breast lift surgery
*
Microdochectomy (removal of a
lactiferous duct
Lactiferous ducts are ducts that converge and form a Morphogenesis#Branching morphogenesis, branched system connecting the nipple to the lobules of the mammary gland. When lactogenesis occurs, under the influence of hormones, the breast milk, mil ...
)
* Surgery for
breast abscess, including
incision and drainage as well as excision of lactiferous ducts
* Surgical
breast biopsy
Complications
After surgical intervention to the breast, complications may arise related to
wound healing
Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue.
In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier again ...
. As in other types of surgery,
hematoma (post-operative bleeding),
seroma (fluid accumulation), or incision-site breakdown (wound infection) may occur.
Breast hematoma due to an operation will normally resolve with time
but should be followed up with more detailed evaluation if it does not.
Breast abscess can occur as post-surgical complication, for example after cancer treatment or reduction mammaplasty.
[Noel Weidner, Chapter ''Infections of the breast'' (pp. 34–43). In: ] Furthermore, if a breast has already undergone irradiation (as in
radiation therapy
Radiation therapy or radiotherapy (RT, RTx, or XRT) is a therapy, treatment using ionizing radiation, generally provided as part of treatment of cancer, cancer therapy to either kill or control the growth of malignancy, malignant cell (biology), ...
for treating breast cancer), there is a heightened risk of complications (e.g. reactive inflammation, occurrence of a chronic draining wound, etc.) for breast biopsies or other interventions to the breast, even those often considered "minor" surgeries.
The combined effects of radiation and breast cancer surgery can in particular lead to complications such as breast
fibrosis, secondary
lymphoedema (which may occur in the arm, the breast or the chest, in particular after
axillary lymph node dissection), breast asymmetry, and chronic/recurrent breast
cellulitis
Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of ...
, each of these having long-term effects.
Ultrasound
Ultrasound is sound with frequency, frequencies greater than 20 Hertz, kilohertz. This frequency is the approximate upper audible hearing range, limit of human hearing in healthy young adults. The physical principles of acoustic waves apply ...
can be used to distinguish between seroma, hematoma, and
edema in the breast. Further possible complications are
fat necrosis (premature cell death of fat cells) and scar retraction (shrinking of the area around the surgical scar). In rare cases after breast reconstruction or augmentation, late seroma may occur, defined as seroma occurring more than 12 months postoperatively.
There is preliminary evidence suggesting that
negative-pressure wound therapy may be useful in healing complicated breast wounds resulting from surgery.
Postoperative pain is common following breast surgery. The incidence of poorly controlled acute postoperative pain following breast cancer surgery ranges between 14.0% to 54.1%.
Regional anaesthesia is superior compared to
general anaesthesia for the prevention of
persistent postoperative pain three to 12 months after breast cancer surgery.
In post-surgical medical imaging, many findings can easily be mistaken for cancer.
Postsurgical breast imaging
Medscape, last updated 11 November 2013 In MRI, scars that occurred many years before are normally "silent".
References
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