Sectoral resection of the mammary gland

Diseases of the breast - not a rare phenomenon in women. Unfortunately, not all such diseases can be cured by a conservative way - often you have to resort to surgical intervention. Today we will talk about an operation such as sectoral breast resection - this is the removal of the site (sector) of the organ.

[1], [2], [3]

Indications for sectoral resection of the breast

The main indication for the removal of the breast sector is a tumor.

The sector is not a clear area - it's a rather vague concept, which represents about the sixth or eighth part of the body.

As is known, neoplasms are of benign and malignant nature. Resection can be carried out in the first and second cases, especially if the tumor provokes pathological disorders that can not be eliminated in any other way.

Malignant diseases of the breast include cancer, sarcoma and oncology of other tissue structures of the gland.

Of benign diseases of operative intervention may require fibroadenoma, lipoma, mastopathy, cyst, papilloma (including intra-flow) and cystic mastopathy. In the list of operable diseases, chronic mastitis and other chronic purulent processes can also be introduced.

Technique of operation

Before the operation, the surgeon consults the patient, explaining to him how the intervention will occur, what are the dangers and difficulties, etc. Much attention is paid to the question of anesthesia during resection, the presence of allergy in the patient is checked. Additional types of studies may be prescribed, for example, ultrasound, mammogram, blood and urine tests, and a cardiogram.

Radical sectoral breast resection is the complete removal of an organ site that is supposed to contain a cancerous or benign neoplasm. The type of anesthesia is chosen depending on the type and complexity of the tumor. Be sure to carry out local anesthesia with drugs based on novocaine or lidocaine. General anesthesia is used when the removed formation is not probed and can be considered only on ultrasound or with the help of a mammogram, and also if removal of the gland sector is part of the organ-preserving operation.

How is surgery performed?

Immediately before the operation, the doctor plans to place the glands of the site of the proposed incisions. This is done, as a rule, under the supervision of ultrasound - so the surgeon can perform a precise resection, removing only the necessary tissues.

After the beginning of the anesthesia, the doctor conducts incisions along the originally laid lines. The gland tissues are cut as two curved lines radially relative to the nipple. After this, a cut is made on the other side, retreating approximately 3 cm from the border of the tumor to the edge of the large pectoral muscle deep into the organ. At the same time, the surgeon directly restrains the formation itself. Skin covers are separated from the underlying layers of tissue. Next, the doctor determines the location of the edges of the tumor and excise it, removing the pathological site.

Immediately after excision, measures are taken to hemostasis - stop bleeding. The wound is sutured layer by layer: separately there is a cross-linking of the subcutaneous tissue and cosmetic stitching of the skin. In order to avoid accumulation of discharge, drainage is established for the first day or two in the wound. Place a sterile bandage on the incision site.

After the operation, the removed tissue is sent to the histology - a qualitative study of the tissues. If the analysis confirms the malignant nature of the tumor, then the oncologist takes the matter of further treatment and possible repeated surgery.

Carrying out of a sectoral resection provides for the obligatory finding of a patient in stationary conditions.

The average duration of surgery is from 30 to 45 minutes.

Complications after sectoral resection of the breast

Surgery for sectoral resection is considered a relatively safe surgical intervention. However, complications, even if not so dangerous, are possible here.

Perhaps the emergence and growth of an inflammatory reaction at the site of the incision, which may be a consequence of infection into the wound. The inflammatory process can develop into a suppurative. In order to prevent such a consequence, after the operation the patient is prescribed antibiotic therapy. However, if the purulent process has already begun, the surgeon conducts the opening of the wound, cleans the tissues from purulent discharge, treats with solutions of antibiotics and establishes drainage.

Another possible complication - compaction after sectoral resection of the breast - may be the result of blood clots, or simply, hematomas. This can be observed with insufficient stopping of bleeding, or in the presence of problems with normal blood coagulability. Hematoma can be detected with the help of ultrasound. It is not allowed to use any thermal procedures (heaters, compresses, etc.).

If there is a clump of blood inside the tissues, it must be eliminated. To do this, the wound surface is dissected, the accumulated blood is removed, the cavity is rinsed with an antibacterial solution, and drainage is established.

Pain after sectoral resection of the breast, as a rule, is not considered a complication, unless they are caused by the growth of the hematoma or the development of the inflammatory process. In most cases, the pain appears due to the growth of scar tissue, which can be manifested by low-intensity pain for up to 2 months. Causes of pain should be clarified by ultrasound or mammography.

[4], [5], [6], [7], [8], [9]

Postoperative period

As we said above, the patient after the operation continues his stay in the hospital under the supervision of a doctor. In most cases, if the patient's well-being is considered satisfactory, then within 1-2 days the doctor prepares him for an extract.

Before discharge the doctor again attentively examines the surgical intervention area, removes the established drainage, processes and bandages the wound. After that, he signs further treatment, which will be conducted at home. Typically, this treatment includes:

• taking pain medications to eliminate and alleviate possible pain in the postoperative period;
• antibiotic therapy to prevent the appearance and spread of infection in the wound.

Sutures are removed about a week or 10 days after surgery.

As well as after any operation, after sectoral resection, the formation of scar tissue at the incision site is mandatory. The nature of the developing scar may depend on how accurate the surgeon was during the operation, from further wound healing (complications, inflammatory reactions), and also from the patient's body and the state of its immunity.

Rehabilitation after sectoral resection of the breast

Diseases of the breast are directly related to the state of the reproductive system of women in general. Neoplasms of the mammary glands almost always occur against the background of inflammatory processes in the small pelvis, endometrial hyperplasia, uterine fibroids, monthly cycle disorders, cysts of the appendages, endometriosis, infertility. Thyroid and liver pathologies also affect the health of the breast.

Consequently, each woman should receive from the doctor an individual scheme of rehabilitation after surgery, which should consist of the following activities:

• therapy of existing gynecological pathologies;
• the normalization of the balance of hormones in the body;
• prevention of unplanned pregnancy;
• prevention of lactation disorders, control of an adequate lactation period;
• compliance with diet, vitamin intake, preventive intake of alternative herbal remedies;
• regular visits to specialized specialists - endocrinologist, neurologist, psychotherapist, infectious diseases specialist.

It is recommended to take a course of sessions of psychotherapy. Possible simultaneous administration of nootropic drugs, cardiovascular drugs, multivitamins (with vitamins of group B, ascorbic acid, vitamin E and lipoic acid in the composition). From herbal preparations, preference is given to medicines based on motherwort, eleutherococcus, Manchu aralia, rhizome of valerian, mint leaves (for example, saparal, novopassit).

Individually selected diet with a decrease in the intake of animal fats and an increase in the number of consumed products of plant origin. Welcome to the inclusion in the daily menu of sour-milk products, eggs, vegetable oils. The consumption of fatty meat products, fried dishes is excluded.

The proposed scheme of rehabilitation provides a reduction in the risk of repeated development of breast pathology, for which an operation was performed.

Recommendations after sectoral resection of the breast

Any operation, even the most simple and with minor tissue damage, is considered a stressful situation for the patient's body. Therefore, experts recommend their patients for the day before the surgery to take sedatives, can be of vegetable origin.

If surgical intervention is carried out under local anesthesia, and the patient thus feels pain (even insignificant), it is necessary to tell the doctor about it, who will make a decision about the auxiliary administration of anesthetics. To suffer a pain in no event it is impossible.

The first 1-2 days after the operation, the doctor must constantly monitor the patient's condition. Therefore, if the doctor decides that the patient should stay for another day in the clinic, then there are good reasons for that.

The patient should exactly follow all the advice of the attending physician: take all prescribed medications, regularly make bandages, adhere to the medication regimen.

Sectoral resection of the breast is an organ-preserving intervention, however, in some cases, a plastic surgeon may be required to restore the aesthetic appearance of the breast.