quadrantectomy


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Related to quadrantectomy: mastectomy

mastectomy

 [mas-tek´to-me]
surgical removal of breast tissue, usually for treatment of malignant breast tumors, although occasionally this may be advisable for benign tumors, other diseases of the breast such as fibrocystic disease of the breast, or prophylaxis. Patients with breast disorders should be informed about all the options for treatment including alternatives to mastectomy. Types of mastectomy include the simple or total mastectomy and radical, modified radical, and extended radical mastectomies.
Patient Care. The psychological aspects of the breast must always be considered in the care of women who face the prospect of loss of breast tissue through surgery. The breast is symbolic of femininity, motherhood, and sexual attractiveness for some individuals. Psychological problems likely to be associated with mastectomy include disturbance in self-concept related to changes in body image, self-esteem, role performance, and personal identity. Newer, less mutilating surgical procedures and cosmetically successful reconstructive plastic surgery (mammaplasty) to replace surgically removed breast tissue have diminished some of the emotional trauma formerly associated with mastectomy.

Following mastectomy the patient is likely to experience such physical problems as pain, numbness, tingling, and weakness related to nerve damage and muscle atrophy. Additionally, the patient is subject to lymphedema and collections of serous fluid (seroma) associated with interruption of the flow of lymph.

In addition to routine postoperative care to prevent pulmonary and circulatory complications, the patient must be watched for the development of localized edema, especially if lymph nodes have been removed. In order to provide adequate drainage of serosanguineous fluid that could delay healing of the operative site, the surgeon may insert a flat, narrow drain with multiple openings. The device is part of a portable self-contained closed-suction system that exerts negative pressure. Systems of this kind include Hemovac and Reliavac.

The patient receives routine postoperative care, including coughing and deep-breathing exercises, to prevent respiratory complications and early ambulation to avoid circulatory stasis. When helping the patient from bed it is important to realize that her sense of balance may be impaired because of changes in upper body structures and some hesitancy to use the arm on the operative side to support herself and maintain balance.

Postoperative care should include periodic assessment of sensations (e.g., “phantom breast” sensations) and of functional limitations in the chest wall and affected arm. Additionally numbness, patterns of weakness, and paresthesias are evaluated. The patient should be taught how to recognize and report these symptoms and any changes noted, as they could indicate progressive nerve damage.

Impairment of lymph flow increases the risk of infection. Loss of sensation could predispose the patient to injury from burns, cuts, and other accidental trauma. Venipunctures are not done and blood pressure cuffs are not applied on the arm on the affected side. Prior to discharge the patient is given instruction in ways to avoid trauma: for example, do not carry a heavy handbag or other heavy articles with the affected arm, avoid excessive exposure to sun, do not pick or cut cuticles, and consult the physician or nurse before having vaccinations or injections in the affected arm. Exercises to improve mobility and lymphatic drainage are begun while the patient is in the hospital and continued by her after discharge. These exercises are described and illustrated in the booklet “Help Yourself to Recovery,” which is available from local offices of the American Cancer Society. The Cancer Society also has self-help support groups, called Reach for Recovery, for women following mastectomy.

The woman is encouraged to continue follow-up care, including a clinical breast exam every 3 to 4 months for the first 3 years, then every 6 months for 2 years, and thereafter every 6 to 12 months. Annual mammograms should be obtained and the woman should perform breast self-exams monthly.
Halsted mastectomy radical mastectomy.
partial mastectomy removal of the tumor, along with varying amounts of surrounding normal tissue. See also lumpectomy and quadrantectomy. Called also segmental mastectomy.
radical mastectomy removal of the breast, pectoral muscles, axillary lymph nodes, and associated skin and subcutaneous tissue in treatment of breast cancer.
In a radical mastectomy, breast tissue, nipple, underlying muscles, and lymph nodes are removed. From Ignatavicius and Workman, 2001.
radical mastectomy, extended supraradical mastectomy; surgical removal of the internal mammary chain of lymph nodes, the entire involved breast, the underlying chest muscles, and the lymph nodes in the axilla.
radical mastectomy, modified surgical removal of the entire involved breast, and many lymph nodes in the axilla. The underlying chest muscles are removed in part or are left in place after removal of axillary lymph nodes.
In a modified radical mastectomy, breast tissue, nipple, and lymph nodes are removed, but muscles are left intact. From Ignatavicius and Workman, 2001.
segmental mastectomy partial mastectomy.
simple mastectomy surgical removal of the entire involved breast; the underlying chest muscles and axillary lymph nodes are not removed. More recently called total mastectomy.
In a simple mastectomy, breast tissue and (usually) nipple are removed, but lymph nodes are left intact. From Ignatavicius and Workman, 2001.
subcutaneous mastectomy excision of breast tissue with preservation of overlying skin, nipple, and areola so that the breast form may be reconstructed.
supraradical mastectomy extended radical mastectomy.
total mastectomy simple mastectomy.

quadrantectomy

Surgery The excision of a quadrant of tissue, usually from the breast, which includes both grossly identifiable malignancy and grossly normal soft-tissue margins. Cf Lumpectomy, Mastectomy.

quadrantectomy

A limited operation for breast cancer in which only the quadrant of the breast containing the cancer is removed. Quadrantectomy is now less often performed than LUMPECTOMY.
References in periodicals archive ?
Body image was the only factor influenced by the type of surgery (mastectomy or quadrantectomy) and chemotherapy intervention (present or not).
Osborne, as an author on the subject, was well aware that a mastectomy, rather than a quadrantectomy, was the standard of care for the treatment of angiosarcoma.
Comparing radical mastectomy with quadrantectomy axillary dissection, and radiotherapy in patients with small cancers of the breast.
Larger defects such as those resulting from quadrantectomy cannot be adequately filled by simple mobilisation and require creation of a formal flap of local breast tissue.
One of the studies included 701 women who had tumors that were no bigger than 2 cm in diameter and were randomized to treatment with a radical mastectomy or a quadrantectomy, followed by radiotherapy to the ipsilateral mammary tissue.
* Quadrantectomy (removal of a quadrant of the breast).
Keywords: Oncoplastic breast surgery, quadrantectomy (surgery for breast cancer based on tumour location), breast surgery
For BCS, we can use different techniques, for example, quadrantectomy (wide excision), segmentectomy (wide local excision), and lumpectomy (local excision).
spindle cell sarcoma 15 Epithelioid and spindle cell Poorly differentiated, possibly tumor cells sarcomatoid carcinoma 16 Highly necrotic neoplasm Sarcomatoid carcinoma; with palisading cell malignant schwannoma arrangement 17 Epithelioid and spindle Poorly differentiated, possibly cell tumor cells sarcomatoid carcinoma 18 Epithelioid and spindle Metastatic melanoma tumor cells 19 Epithelioid and spindle Metastatic melanoma tumor cells 20 Epithelioid and spindle Metastatic melanoma tumor cells Abbreviations: CNB, core/needle biopsy; QB, quadrant biopsy/ quadrantectomy; SLN, sentinel lymph node.
According to the International Association for the Study of Pain (IASP) [8] and recent studies [3,7], we defined PMPS as chronic pain in the anterior aspect of the thorax, axilla, and/or upper half of the arm beginning after mastectomy or quadrantectomy and persisting either continuously or intermittently for more than three months after the surgery, and the pain nature included numbness, pins and needles, burning, or stabbing.
Earlier, the same group had assessed the safety of oncoplastic surgery by studying 30 consecutive patients who had oncoplastic surgery and compared them with another 30 patients who had a standard quadrantectomy [9].
It may be a lumpectomy, which only removes the cancerous tissue and some surrounding tissue or a quadrantectomy which takes away slightly more.