When doctors treat breast cancer, their goal is to remove all of the cancer -- or as much of it as possible. Surgery is one of the mainstays of treatment, and today a procedure called modified radical mastectomy (MRM) has become a standard surgical treatment for early-stage breast cancers.
Modified radical mastectomy is especially helpful for early-stage breast cancer that has spread to the lymph nodes. Studies show that MRM is just as effective as radical mastectomy, but not nearly as disfiguring. MRM spares one or both of the chest muscles, preventing an unsightly hollow in the chest that is common after a traditional radical mastectomy.
Evista, also called raloxifene, is a medication that's used to reduce the risk of invasive breast cancer in postmenopausal women. It's also used to reduce the risk of spinal fractures related to osteoporosis. It was during studies of the use of Evista to treat osteoporosis that researchers noticed that among post-menopausal women who took the drug there was a lower rate of invasive breast cancer. After additional studies, the FDA approved the use of Evista for prevention of breast cancer.
During a modified radical mastectomy, the surgeon removes the breast (including the skin, breast tissue, areola, and nipple) and most of the lymph nodes under the arm. The lining over the large muscle in the chest called the pectoralis major is also removed. However, this surgery spares the pectoralis major muscle itself.
MRM surgery tries to preserve enough healthy tissue and skin for a surgeon to perform breast reconstruction surgery in women who want to have it done.
What to Expect During an MRM
A modified radical mastectomy takes about two to four hours. The surgery might take longer if you have breast reconstruction surgery done immediately afterward.
While you are under general anesthesia, the surgeon will make a single incision across one side of the chest. The skin will be pulled back. Then the doctor will remove the entire breast tissue, the lining over the pectoralis major, as well as some of the lymph nodes under your arm. Finally, the doctor will close the incision.
The goal is to remove the cancer while preserving as much of the skin and tissue as possible so that you can have breast reconstruction. The surgeon also will try to avoid damaging nearby blood vessels and nerves.
Although research has found modified radical mastectomy to be generally safe and effective, like all surgical procedures it can have risks, which include:
Swelling of the arm
Pockets of fluid forming underneath the incision (seromas)
Risks from general anesthesia
Some people experience numbness in the upper arm, which is caused by damage to small nerves in the area where the lymph nodes are removed. There is a good chance that you will regain most of the feeling in your arm over time.
The lymph nodes that are removed will be sent to a lab for examination to determine whether the cancer has spread.