Mastectomy - Breast Cancer Surgery
Have you been diagnosed with breast cancer and a mastectomy has been recommended? Mastectomy in Tunisia is a surgical procedure that removes all or part of the breast to treat breast cancer. In Tunisia, experienced breast surgeons perform this procedure at competitive prices, with modern techniques and comprehensive care.
What is a mastectomy?
Mastectomy is a surgical procedure that removes all or part of the breast to treat breast cancer. It is one of the basic treatments for breast cancer, often combined with axillary lymph node dissection (removal of lymph nodes from the armpit). Depending on tumor extension, breast size and patient preferences, several types of mastectomy are distinguished.
Types of mastectomy
Several types of mastectomy exist depending on the extent of resection. Partial mastectomy removes only the tumor with a margin of healthy tissue. It preserves the rest of the breast intact. Total mastectomy removes the entire breast without removal of the pectoral muscles. Modified radical mastectomy removes the breast with axillary lymph node dissection. Halsted radical mastectomy removes the breast, pectoral muscles and lymph nodes. This technique is rare today.
Indications for partial mastectomy
Partial mastectomy is offered when the tumor is single and measures less than 3 to 4 cm. It must be well defined to be resectable. The breast must have sufficient volume for an acceptable aesthetic result. No multiple lesions such as extensive ductal carcinoma in situ should be present. Post-operative radiation therapy is mandatory after any lumpectomy. The patient must wish to preserve her breast. Local recurrence rates are equivalent to those after total mastectomy.
Indications for total mastectomy
Total mastectomy is indicated in several situations. A large tumor greater than 4-5 cm requires this procedure. Multiple, multifocal or multicentric tumors are another indication. Extensive ductal carcinoma in situ justifies a mastectomy. Diffuse microcalcifications throughout the gland impose this procedure. Local recurrence after lumpectomy and radiation therapy is an indication. Patients carrying a BRCA mutation may benefit from prophylactic bilateral mastectomy. A contraindication to radiation therapy is also an indication.
Breast reconstruction
Breast reconstruction restores volume and shape to the breast after mastectomy. It can be immediate or delayed. Implant reconstruction uses a silicone implant under the pectoral muscle. The latissimus dorsi muscle flap is another technique. The DIEP flap uses abdominal skin and fat without muscle. The result is very natural with this technique. The TUG flap comes from the inner thigh. Reconstruction of the areola-nipple complex is done by tattooing or grafting. 3D reconstruction is also possible.
The procedure
Mastectomy is performed under general anesthesia. The procedure lasts 1 to 3 hours. Preoperative marking by ultrasound or hook wire placement may be necessary. The incision is elliptical around the areola. Partial mastectomy removes the tumor with a margin of healthy tissue. Total mastectomy removes the entire mammary gland. Axillary procedure includes lymph node dissection. Sentinel lymph node biopsy is possible. Breast reconstruction can be immediate or delayed. Closure uses aesthetic sutures and drains. Drains are placed for 1 to 3 days.
Post-operative recovery
Recovery after mastectomy is generally well tolerated. Hospitalization lasts 2 to 5 days depending on the extent. Drains are removed in 1 to 3 days. Pain is moderate and controlled with painkillers. Arm mobility is preserved from the first day with physiotherapy. Return to work is 4 to 8 weeks depending on the profession. Radiation therapy begins 4 to 6 weeks after surgery if necessary. Chemotherapy or hormone therapy may be indicated according to the pathological report.
Risks and complications
Like any surgery, mastectomy carries risks that remain rare. Hematoma or seroma may occur. Aspiration is sometimes necessary. Wound infection is rare. Skin necrosis is exceptional. Arm lymphedema occurs in 10 to 20% of cases after axillary dissection. Physiotherapy and sleeve help prevent it. Post-mastectomy neuropathic pain is often transient. Complications of reconstruction include capsular contracture. Flap necrosis is also possible. Local recurrence is rare, less than 5% after total mastectomy.
Prognosis after mastectomy
Prognosis of breast cancer depends on stage and tumor characteristics. For localized stage I cancer, 10-year survival exceeds 95%. With positive lymph nodes at stages II-III, 10-year survival varies from 60 to 90%. The number of positive lymph nodes influences this rate. At stage IV metastatic, treatment is palliative. Median survival is 3 to 5 years. Favorable factors are positive hormone receptors. HER2 negative is also favorable. Low grade and absence of emboli are good signs. Annual follow-up with mammography and breast ultrasound is essential.
What is the price of mastectomy in Tunisia?
Tunisia offers very competitive prices for breast cancer surgery. Lumpectomy with sentinel lymph node biopsy costs between €2,500 and €4,000. Simple total mastectomy is priced from €3,000 to €4,500. Total mastectomy with axillary dissection ranges from €3,500 to €5,500. Mastectomy with immediate implant reconstruction costs from €5,000 to €7,000. Mastectomy with flap reconstruction costs from €6,000 to €9,000. Prophylactic bilateral mastectomy without reconstruction is offered from €5,000 to €7,000. Prices include fees, operating room, 3 to 5 nights hospitalization, pre-operative exams and follow-up consultations.
Frequently Asked Questions about Mastectomy
1Is partial mastectomy always followed by radiation therapy?
Yes, partial mastectomy (lumpectomy) is systematically followed by adjuvant radiation therapy on the remaining breast. This radiation reduces the risk of local recurrence by 70%. In some cases, accelerated partial irradiation may be offered for good prognosis tumors.
2Can breast reconstruction be performed at the same time as mastectomy?
Yes, immediate breast reconstruction can be performed in the same surgical procedure as mastectomy. This approach has several advantages: a single surgical time, better skin preservation and often superior aesthetic results. It is possible with implants or flaps depending on the case.
3What is the hospitalization duration for a mastectomy?
The hospitalization duration for a mastectomy varies depending on the type of procedure. A lumpectomy with sentinel lymph node biopsy is performed on an outpatient basis or with an overnight stay. A total mastectomy requires 2 to 5 days of hospitalization. In case of immediate reconstruction, hospitalization may be extended by 1 to 2 days.
4Does mastectomy affect arm or shoulder sensitivity?
Mastectomy can cause decreased sensitivity of the arm and shoulder on the operated side. These issues are related to the manipulation of cutaneous nerves. Sensitivity generally returns within a few months. Early physiotherapy is recommended to prevent stiffness and pain.
5Can I breastfeed after a partial mastectomy?
Partial mastectomy can affect milk production in the operated breast. Breastfeeding capacity depends on the amount of remaining glandular tissue and the surgical technique. In most cases, breastfeeding is possible but with reduced milk quantity. A consultation with a midwife is recommended to assess the possibilities.
6What is the difference between a simple mastectomy and a radical mastectomy?
Simple mastectomy (or total) removes only the mammary gland and the areola-nipple complex. Modified radical mastectomy also removes level I and II axillary lymph nodes. Halsted radical mastectomy, which removes the pectoral muscles, is now exceptional. The choice depends on tumor extension.
7When can I return to work after a mastectomy?
Return to work after a mastectomy depends on the nature of the professional activity and the type of procedure. For office work, return is possible after 4 to 6 weeks. For physical jobs or those involving arm movements, a leave of 8 to 12 weeks is generally recommended. The surgeon's advice is essential.
Why choose Tunisia for a mastectomy?
Tunisia is a recognized destination in breast oncology. Its breast surgeons are experienced and trained in Europe. Modern technical platforms include digital mammography, ultrasound and breast MRI. Breast reconstruction uses implants and DIEP flaps. Prices are competitive with savings of 50 to 70%. Management is multidisciplinary between surgeons, oncologists and radiotherapists. The procedure is scheduled quickly, within 2 to 3 weeks. Personalized support is offered for administrative and psychological support.
In Conclusion
Partial or total mastectomy remains a reference treatment for breast cancer, providing excellent cure rates. In Tunisia, Tunisie Esthetic offers you quality surgical care, performed by experienced breast surgeons, with modern techniques and competitive prices. Feel free to contact us to discuss your situation and obtain a personalized quote.