Toilet mastectomy for advanced breast cancer.

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Toilet mastectomy continues to be a important adjunct to palliation in metastatic and locally advanced breast cancer.

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Toilet mastectomy for advanced breast cancer.

  1. 1. Toilet mastectomy: A useful adjunct to palliativeToilet mastectomy: A useful adjunct to palliativecare in metastatic and locally advanced breastcare in metastatic and locally advanced breastcancer patientscancer patients..Dr.Ketan VagholkarMS,DNB,MRCS,FACS.Consultant General Surgeon
  2. 2. Toilet mastectomy: A useful adjunct to palliativeToilet mastectomy: A useful adjunct to palliativecare in metastatic and locally advanced breastcare in metastatic and locally advanced breastcancer patientscancer patients.. Toilet mastectomycontinues to be aexcellent adjunct topalliative care inadvanced breast cancerpatients. Local complicationssuch as bleeding andsecondary infection withsloughing of the growthare most distressful tothe patient. A well done toiletmastectomy canprovide satisfactoryrelief from thesecomplications. The response tochemotherapy is alsoquite better.
  3. 3. Salient features of toilet mastectomy.Salient features of toilet mastectomy. Wide excision taking into consideration thelimitations imposed by the paucity ofsurrounding skin for closure. Reaching up to the muscle and in some casesremoving a part of the adherent muscle fibers. Avoid going into the axilla in view of adherentlymph node masses engulfing the axillaryvessels. Rigorous intraoperative lavage with hypertonicsaline to destroy spilled cancer cells duringsurgery.
  4. 4. Clinical CaseClinical Case 68 year old lady withlocally advancedbreast cancer withliver metastases andlocal complicationsof severe intermittentbleeding from thegrowth.
  5. 5. Specimen removed at toiletSpecimen removed at toiletmastectomymastectomy The entire fungatingmass along with anarrow rim of skin isremoved. The deep dissectionshould extend uptothe underlyingpectoral muscles.
  6. 6. Final outcome of surgeryFinal outcome of surgery
  7. 7. Final outcome of surgeryFinal outcome of surgery

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