What Is Modified Radical Mastectomy (MRM)?

Modified Radical mastectomy is a procedure in which the whole breast is taken out, including the skin, areola, nipple, and most of the lymph nodes in the armpit, only the pectoralis major muscle is left. In the past, the most common way to treat breast cancer was with a modified radical mastectomy. As ways to treat breast cancer have changed over time, breast conservation has become more common. However, women with breast cancer can still choose to have a mastectomy.

What a modified radical mastectomy is for?

When a person has surgery to treat cancer, the main goal is to get rid of as much cancer as possible. There are options that don’t involve surgery, but they may not work as well. Because of this, doctors may suggest a modified radical mastectomy if you have breast cancer (MRM).

During an MRM, the entire breast, including the skin, breast tissue, areola, and nipple, as well as most of the armpit lymph nodes, are removed. Most of the chest muscles, on the other hand, are still there.

There are two different MRM surgeries:

• Patey’s surgery (Patey modified radical mastectomy). In this type, the pectoralis major muscle stays, but the pectoralis minor muscle goes away.
• The operation by Auchincloss (Auchincloss modified radical mastectomy). Both the pectoralis major and the pectoralis minor are still there in this type.

The MRM is a common treatment for breast cancer. The method can be used to treat breast cancer in both men and women.

Modified radical mastectomy procedure:

The main goal of an MRM is to get rid of all or most cancer while keeping as much healthy skin as possible. This means that after you have healed well, you can have a successful breast reconstruction.

Talk to your doctor to find out exactly what you need to do before your surgery. Usually, getting ready means stopping some medications or supplements. You might also be told to use a special soap that kills germs.

You will be given general anaesthesia for an MRM.

Then, your doctor will make marks on your chest to get ready for cuts. Your doctor will make one cut across your chest and carefully pull back your skin far enough to remove your breast tissue. Most of the lymph nodes under your arm will also be taken out.

Usually, the whole process takes between 2 and 3 hours.

Which patients typically undergo an MRM?

When breast cancer is at an advanced stage for example larger tumour size, involvement of nipple or the lymph nodes in the armpit, a patient may be advised to undergo an MRM. To treat breast cancer, MRM can be used in cases when it is advisable to remove the entire breast or when radiation therapy cannot be given after surgery.

Many women with early-stage cancer can choose between breast-conserving surgery (BCS) and mastectomy. You might want a mastectomy to “get rid of all cancer as soon as possible.” But the truth is that most of the time, a mastectomy does not improve your chances of living longer than BCS.

Studies of thousands of women over more than 20 years show that when BCS is done along with radiation, the result is the same as having a mastectomy.

You might be told to get a mastectomy if:

• Cannot get radiation treatment
• Instead of radiation therapy, would rather choose to remove entire breast.
• Have had radiation therapy on the breast before. Have already had BCS with re-excision(s) that didn’t get rid of cancer completely.
• Have two or more areas of cancer in different parts of the same breast (multicentric) that are not close enough to be removed together without changing the look of the breast too much.
• Have a tumour that is bigger than 5 cm (2 inches) or that is big for the size of your breast
• Are pregnant and would need radiation therapy while they are still pregnant (risking harm to the fetus)
• Have a genetic change like a BRCA mutation, which could make you more likely to get second cancer.
• Have a serious connective tissue disease like scleroderma or lupus, which may make you more sensitive to the side effects of radiation therapy.
• Have breast cancer that is inflamed.

For women who are worried about their breast cancer coming back, it is important to know that having a mastectomy instead of breast-conserving surgery plus radiation only lowers the risk of getting a second breast cancer in the same breast. It doesn’t make it less likely that cancer will spread to other parts of the body, like the other breast.

Radical mastectomy vs. modified radical mastectomy

In a radical mastectomy, the whole breast is removed, including the skin, breast tissue, areola, and nipple. This is similar to the MRM. But the chest muscles also have to be cut out during this procedure.

The most invasive surgery for breast cancer is the radical mastectomy. It is only considered if a doctor finds a tumour that has spread into the chest muscles.

Radical mastectomy was once a more common way to treat breast cancer, but now it is rarely done. People who get the radical mastectomy and those who get the MRM have about the same chance of beating cancer. The MRM has shown to be a less invasive method that works just as well.

A simple mastectomy vs. a modified radical mastectomy

Total mastectomy is another name for a simple mastectomy. During this surgery, the whole breast is taken off. In some cases, some lymph nodes in the armpit may also be taken out.

The main difference between an MRM and a regular mastectomy is that lymph nodes are taken out of the armpit during an MRM.

When it comes to Breast-cancer surgery, Dr Mansi is the best to reach.

Dr Mansi Chowhan is a well-known surgical oncologist who has worked in the field for more than 12 years. She is a very good surgeon because she is an expert in breast oncoplastic, head and neck surgery, and reconstructive surgery.

Dr Mansi has been a doctor for more than 12 years and has worked at some of the best hospitals in the Delhi-National Capital Region (NCR), such as Fortis Healthcare (Delhi and Gurgaon), Artemis Hospital (Gurgaon), Paras Hospital (Gurgaon), and the Asian Institute of Medical Sciences (Faridabad).

The Onco Team