Sectoral breast resection

Breast diseases are not a rare occurrence in women. Unfortunately, not all such diseases can be treated conservatively - often it is necessary to resort to surgical intervention. Today we will talk about such an operation as sectoral resection of the mammary gland - this is the removal of a section (sector) of the organ.

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Indications for sectoral resection of the mammary gland

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

A sector is not a clear area – it is a rather vague concept that represents approximately one sixth or eighth of the organ.

As is known, neoplasms can be benign and malignant. Resection can be performed in both cases, especially if the tumor provokes pathological disorders that cannot be eliminated in any other way.

Malignant breast diseases include cancerous tumors, sarcomas and oncology of other tissue structures of the gland.

Benign diseases that may require surgical intervention include fibroadenoma, lipoma, mastopathy, cyst, papilloma (including intraductal) and cystic mastopathy. Chronic mastitis and other chronic purulent processes can also be added to the list of operable diseases.

Technique of operation

Before the operation, the surgeon consults the patient, explaining to him how the intervention will take place, what dangers and difficulties exist, etc. Much attention is paid to the issue of pain relief during the resection, the patient is checked for allergies. Additional types of examinations may be prescribed, for example, ultrasound, mammogram, blood and urine tests, cardiogram.

Radical sectoral resection of the mammary gland is the complete removal of a section of the organ that is suspected of containing a cancerous or benign neoplasm. The type of anesthesia is selected depending on the type and complexity of the tumor. Local anesthesia with drugs based on novocaine or lidocaine is mandatory. General anesthesia is used when the formation being removed is not palpable and can only be seen on ultrasound or with a mammogram, and also if the removal of a sector of the gland is part of an organ-preserving operation.

How does the surgery proceed?

Immediately before the operation, the doctor marks the sites of the proposed incisions on the skin of the gland. This is usually done under ultrasound control - this way the surgeon can accurately perform the resection, removing only the necessary tissues.

After the anesthesia begins to work, the doctor makes incisions along the initially drawn lines. The gland tissue is cut in the form of two curved lines radially relative to the nipple. After this, an incision is made on the other side, retreating approximately 3 cm from the border of the neoplasm to the edge of the large pectoral muscle deep into the organ. At the same time, the surgeon holds the formation itself with his hand. The skin is separated from the underlying tissue layers. Then the doctor determines the location of the edges of the tumor and excises it, removing the pathological area.

Immediately after excision, hemostasis measures are taken to stop the bleeding that has occurred. The wound is sutured layer by layer: the subcutaneous tissue is sutured separately and the skin is cosmetically sutured. In order to avoid the accumulation of secretions, drainage is installed in the wound for the first day or two. A sterile bandage is applied to the incision site.

After the operation, the removed tissues are sent for histology – a qualitative examination of the tissues. If the analysis confirms the malignant nature of the tumor, then the question of further treatment and possible repeated surgical intervention is decided by the oncologist.

Carrying out a sectoral resection requires the patient to remain in hospital.

The average duration of surgery is 30 to 45 minutes.

Complications after sectoral resection of the mammary gland

Sector resection surgery is considered a relatively safe surgical intervention. However, complications, even if not so dangerous, are not excluded.

It is possible that an inflammatory reaction may appear and increase at the incision site, which may be a consequence of infection penetrating the wound. The inflammatory process may develop into a purulent one. In order to prevent such a consequence, the patient is prescribed antibiotic therapy after the operation. However, if the purulent process has already begun, the surgeon opens the wound, cleans the tissues from purulent discharge, treats with antibiotic solutions and installs drainage.

Another possible complication – compaction after sectoral resection of the mammary gland – may be the result of blood accumulation, or simply, hematoma. This may be observed if bleeding is not stopped sufficiently, or if there are problems with normal blood clotting. Hematoma can be detected using ultrasound. In this case, it is not allowed to use any thermal procedures (heating pads, compresses, etc.).

If blood accumulation is detected inside the tissue, it must be eliminated. To do this, open the wound surface, remove the accumulated blood, wash the cavity with an antibacterial solution and install drainage.

Pain after sectoral resection of the mammary gland is usually not considered a complication, unless it is caused by the growth of a hematoma or the development of an inflammatory process. In most cases, pain occurs due to the growth of scar tissue, which can manifest itself as mild pain for up to 2 months. The causes of pain should be determined using ultrasound or mammography.

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Postoperative period

As we have already said above, the patient after the operation continues his stay in the hospital under the supervision of the doctor. In most cases, if the health of the operated patient is considered satisfactory, then after 1-2 days the doctor prepares him for discharge.

Before discharge, the doctor carefully examines the surgical area once again, removes the installed drainage, treats and bandages the wound. After that, he prescribes further treatment, which will be carried out at home. As a rule, such treatment includes:

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

The stitches are removed approximately one week to 10 days after surgery.

As with any surgery, after sectoral resection, scar tissue is bound to form at the incision site. The nature of the scar that forms may depend on how careful the surgeon was during the surgery, on the subsequent healing of the wound (complications, inflammatory reactions), as well as on the patient's body and the state of his or her immunity.

Rehabilitation after sectoral resection of the mammary gland

Diseases of the mammary gland are directly related to the state of the female reproductive system as a whole. Breast tumors almost always occur against the background of inflammatory processes in the small pelvis, endometrial hyperplasia, uterine fibroids, menstrual cycle disorders, appendage cysts, endometriosis, and infertility. Thyroid and liver pathologies also affect breast health.

Therefore, each woman should receive an individual rehabilitation plan after surgery from her doctor, which should consist of the following activities:

• therapy of existing gynecological pathologies;
• normalizing the balance of hormones in the body;
• prevention of unplanned pregnancy;
• prevention of lactation disorders, control of adequate lactation period;
• following a diet, taking vitamins, and taking herbal folk remedies as a preventative measure;
• regular visits to specialized specialists - endocrinologist, neurologist, psychotherapist, infectious disease specialist.

It is recommended to undergo a course of psychotherapy sessions. It is possible to simultaneously prescribe nootropic drugs, cardiovascular drugs, multivitamins (with B vitamins, ascorbic acid, vitamin E and lipoic acid in the composition). Of herbal preparations, preference is given to drugs based on motherwort, eleutherococcus, Manchurian aralia, valerian rhizome, mint leaves (for example, saparal, novopassit).

A diet is selected individually with a decrease in the consumption of animal fats and an increase in the amount of consumed plant products. The inclusion of fermented milk products, eggs, and vegetable oils in the daily menu is welcomed. The consumption of fatty meat products and fried dishes is excluded.

The proposed rehabilitation scheme reduces the risk of recurrence of the pathology of the mammary gland for which the operation was performed.

Recommendations after sectoral resection of the mammary gland

Any operation, even the simplest one and with minor tissue damage, is considered a stressful situation for the patient's body. Therefore, specialists recommend their patients to take sedatives, possibly of plant origin, a day before surgery.

If the surgical intervention is performed under local anesthesia, and the patient feels pain (even minor), it is necessary to tell the doctor about it, who will decide on the auxiliary administration of anesthetics. Pain should not be tolerated under any circumstances.

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 in the clinic for another day, then there are good reasons for this.

The patient must strictly follow all the advice of the attending physician: take all prescribed medications, regularly change dressings, and adhere to the medication regimen.

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