Skin-sparing Mastectomy

WHAT YOU SHOULD KNOW:

A skin-sparing mastectomy (SSM) is surgery to remove breast tissue and leave the skin over the breast. SSM is done to treat breast cancer and keep cancer from spreading. Only the nipple and areola (dark circle around the nipple) are removed. It may also include where you had a biopsy or where there is a tumor close to the skin. SSM is usually done if you plan to have breast reconstruction at the same time. SSM may also be done as a form of prevention if you are at high risk for breast cancer.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • You may bleed more than expected, get an infection, or have trouble breathing after surgery. You may get a blood clot in your arm or leg. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. You may have scars, shoulder stiffness, or swelling around the area where the breast was removed. If SSM is done with breast reconstruction, the breast skin may become folded and deformed. The skin may die and you may need another surgery. The cancer may come back even after successful treatment.

  • If left untreated, breast cancer can spread to other parts of your body, such as your liver, lungs, and brain. It may become life-threatening.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • An IV is a small tube placed in your vein that is used to give you medicine or liquids.

  • Pre-op care: You may be given medicine right before your procedure or surgery. This medicine may make you feel relaxed and sleepy. You are taken on a stretcher to the room where your procedure or surgery will be done, and then you are moved to a table or bed.

  • Monitoring:

    • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.

    • Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.

  • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

During your surgery:

Caregivers will make an incision around your areola. The incision may be larger to include a biopsy scar or the skin over a superficial tumor. The tumor and breast tissue will be removed. The underarm lymph nodes may also be removed through the same incision, or through a second incision under the arm. Caregivers may need to cut more of your skin if you have large breasts. They may then do reconstruction surgery to fill in the empty breast. Thin rubber tubes may be put into your skin to drain blood from your incision. The incisions will then be closed with stitches and covered with bandages.

After your surgery:

You will be taken to a room where you can rest until you are fully awake. Caregivers will monitor you closely. Do not try to get out of bed. When caregivers see that you are okay, you will be taken to your hospital room.

  • Activity: You may need to walk around the same day of surgery, or the day after. This will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. Sit or lie down right away if you feel weak or dizzy.

  • Deep breathing and coughing: This will help decrease your risk for a lung infection after surgery.

    • Hold a pillow tightly against your incision when you cough to help decrease pain. Take a deep breath and hold it for as long as you can. Deep breaths help open your airways. Let the air out and follow with a strong cough. Spit out any mucus you cough up. Repeat the steps 10 times every hour.

    • You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece into your mouth and take a slow, deep breath. Let out your breath and cough. Repeat the steps 10 times every hour.

  • Drains: These are thin rubber tubes put into your skin to drain fluid from around your incision. The drains are taken out when the incision stops draining.

  • Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.

  • Medicines:

    • Antibiotics: This medicine is given to help treat or prevent an infection caused by bacteria.

    • Pain medicine: Caregivers will give you medicine to take away or decrease your pain. Do not wait until the pain is severe to ask for your medicine.

    • Antinausea medicine: This medicine may be given to calm your stomach and to help prevent vomiting.

  • Pneumatic boots: Inflatable boots are put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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