Definition & Overview
A mastotomy refers to the surgical incision of the breast. It is commonly used to explore the said body part and look for signs of disease or to drain an abscess in the area. A breast abscess, which occurs due to the accumulation of pus, causes pain and swelling. Some of them form just under the skin, while some can form deep within the breast. Doctors get rid of them by draining the pus out to allow the skin to heal properly. To do so, a mastotomy is performed.
Who Should Undergo and Expected Results
A mastotomy is necessary for women with suspicious growth in the breast and those who complain of symptoms such as swollen lumps and breast pain.
If the doctor is unsure as to what is causing the symptoms, mastotomy with exploration is performed to make a definitive diagnosis.
If a patient has a breast abscess, the doctor will perform a mastotomy to drain it. However, it is important to note that abscesses that form just underneath the skin can be drained out through a needle aspiration while those that form deep within the breast can be accessed through a mastotomy.
Breast abscesses are commonly caused by bacterial infection or mastitis, which is very common among breastfeeding women. This is because infections can easily occur if the milk ducts become clogged. When left untreated, mastitis can lead to an abscess. However, women who are not breastfeeding can still get breast abscesses. This happens when bacteria enters the breast through a cracked or pierced nipple. Studies show that abscesses are most common among women who are between 18 and 50 years old.
How is the Procedure Performed?
All breast abscesses need to be drained to keep the infection from spreading and causing complications. Abscesses that are small and are near the skin surface can be drained using a needle or syringe. This means that the pus can be aspirated without cutting through the breast. This can be done in a doctor’s office or an emergency room. However, if the abscess is big or deep, a mastotomy is needed.
The following steps are taken to explore breast tissue or drain out an abscess with a mastotomy:
- First, the doctor injects local anaesthesia to numb the breast area. Some patients may need general anaesthesia, especially when the abscess is too deep.
- A cut is then made through the skin of the breast using a scalpel.
- The tissue inside the breast is then explored to find signs of a problem or the cause of the patient's symptoms.
- If there is an abscess, it is cut down to drain out the pus.
- If some glands in the breast are affected, the doctor may also remove them.
If the infection is severe, the patient’s nipple can sometimes become inverted. If this has occurred, the patient can have her nipple reconstructed. This can be done during the same procedure, but it can also be done at a later time.
Most doctors also advise their patients to undergo breast cancer screening after the procedure, especially if they are not breastfeeding. This is because any kind of breast infection in women who do not breastfeed can be a sign of breast cancer.
Possible Risks and Complications
Patients who undergo a mastotomy are at risk of:
- Blood clot
- Delayed healing
- Allergic reactions to the local anaesthesia used
There is also a risk that the breast abscess may recur. But if the breast glands affected by the primary abscess were also removed, this is less likely to happen.
Patients who undergo a mastotomy to drain out an abscess should return to their doctor after 1 to 2 weeks to make sure that the infection is completely gone.
Knight ICS, Nolan B. “Breast Abscess.” Br Med J. 1959 May 9l 1(15131):1224-1226. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1993404/
Kataria K, Srivastava A, Dhar A. “Management of lactational mastitis and breast abscesses: Review of current knowledge and practice.” Indian J Surg. 2013 Dec; 75(6): 430-435. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3900741/