MANAGEMENT

Mastectomy

The main advantage of mastectomy over wide local excision is complete clearance of breast tissue which defines need for adjuvant therapy and in majority of cases avoids local radiotherapy. The loss of breast leads to significant psychological trauma and hypoaesthesia of chest wall and arm pain may have long term physical implications.

Indications
1. Patient's preference after all relevant facts have been explained.
2. Tumour size > 4 cm and not suitable for neo-adjuvant chemo-endocrine therapy.
3. Multi-focal invasive carcinoma.
4. Diffuse ductal carcinoma in-situ ( > 4.5 cm on mammogram, chapter 9)
5. Failure of obtaining clear microscopic margins after two excisions in invasive or in-situ carcinoma.
6. Pregnant patient.
7. Male breast cancer.
8. Local recurrence following breast conservation and radiotherapy.
9. Radiotherapy contra-indicated because of pre-existing medical condition.

Wide Local Excision - Mastectomy
(Please select an option to management technique)

If you require further advice or information please contact the
Macmillan Breast Care Nurses, Hazel Ricard and Hilary Rickwood on 020 8565 5885