The document provides information about mastectomy surgery, including: - A mastectomy is a surgery to remove all breast tissue from the breast to treat or prevent breast cancer. It can remove one or both breasts. - There are different types of breast surgeries including total mastectomy, lumpectomy, and modified radical mastectomy. - Pre-operative nursing assessments for mastectomy include evaluating how the patient is feeling emotionally, explaining the procedure, preparing them physically, and alleviating anxiety. - Perioperative care encompasses pre, intra, and post-operative periods and aims to improve surgical outcomes through the patient-nurse relationship.

1. MASTECTOMY
DICKSON AARON AND TRYPHINA MABULI

2. SPECIFIC OBJECTIVES

3. INTRODUCTION
• The breast is the tissue overlying the chest (pectoral) muscles.
• Women's breasts are made of specialized tissue that produces milk
(glandular tissue) as well as fatty tissue.
• The amount of fat determines the size of the breast. The milk-
producing part of the breast is organized into 15 to 20 sections, called
lobes

4. INTRO…….
• Within each lobe are smaller structures, called lobules, where milk is
produced.
• The milk travels through a network of tiny tubes called ducts.
• The ducts connect and come together into larger ducts, which eventually
exit the skin in the nipple.
• The dark area of skin surrounding the nipple is called the areola.
• Connective tissue and ligaments provide support to the breast and give it
its shape.
• Nerves provide sensation to the breast.
• The breast also contains blood vessels, lymph vessels, and lymph nodes.

5. BREAST CONDITIONS
• breast cancer: Malignant (cancer) cells multiplying abnormally in the
breast, eventually spreading to the rest of the body if untreated. Breast
cancer occurs almost exclusively in women, although men can be affected.
Signs of breast cancer include a lump, bloody nipple discharge, or skin
changes.
• Ductal carcinoma in situ (DCIS): Breast cancer in the duct cells that has not
invaded deeper or spread through the body. Women diagnosed with DCIS
have a high likelihood of being cured.
• Lobular carcinoma in situ (LCIS): Although called a carcinoma LCIS, which
occurs in the milk-producing lobule cells, does not invade or spread and is
not a true cancer. However, women with LCIS have an increased likelihood
of developing invasive breast cancer in the future.

6. BREAST CONDITIONS CONT…..
• Invasive ductal carcinoma: Breast cancer that begins in the duct cells
but then invades deeper into the breast, carrying the potential of
spreading to the rest of the body (metastasizing). Invasive ductal
carcinoma is the most common type of invasive breast cancer.
• Invasive lobular carcinoma: Breast cancer that begins in the milk-
producing lobule cells, but then invades deeper into the breast,
carrying the potential of spreading to the rest of the body
(metastasizing). Invasive lobular carcinoma is an uncommon form of
breast cancer.

7. MASTECTOMY
• A surge to remove all breast tissue from the breast as a way to treat
or prevent breast cancer
• Used to remove all breast tissue for cancer or patients with very high
risk of developing it
• Can either both or one breast

8. Types of breast surgery
• Total (simple) mastectomy
• Removal of breast tissue (lobules, ducts and fatty tissue)and nipple.
• Modified Radical Mastectomy
• removes the breast tissue, armpit lymph nodes, and part of the chest
muscles
• Lumpectomy:
• removes the tumor and the affected area around it

9. Pre- Operative Nursing Assessment for
Mastectomy
• Providing preoperative nursing care for patients ho are to undergo
mastectomy is an integral part of the therapeutic regimen
• Nursing goal
• Provide support
• Alleviating anxiety
• Managing pain
• Providing information

10. cont
• How she feels about the diagnosis
• Whether she knows how the surgery works, and why it’s being done
• If she is coping with it
• Whether she needs any psychological or emotional support
• If she has a relative or friend who can support her
• Is she experiencing any pain or discomfort

11. Preoperative care
• Prepare the patient physically and psychologically in readiness for
operation
• Explain the condition to patient, type of procedure, expected
outcomes and possible complications during and after procedure
• Insert the cannula
• Take the blood sample for hemoglobin level
• Take the blood sample for grouping and cross matching
• Take the baseline vital signs
• Keep the patient of nothing per os from midnight

12. Cont.…….
• Assess the skin and note any obvious skin lesions/ wounds, clean it and
cover with sterile gauze
• Take bath early morning before procedure
• Mark the breast that will be operated
• Insert the urinary catheter
• Assist her to put on hospital gown
• Remove the denture and other materials
• Sign the consent form
• Administer prescribed proph medication
• escort the patient to theatre and give hand over the perioperative nurse

13. Nursing assessment on admission to
operating theatre
• This is the verification what have been done at ward and determine if
patient is fit to be transferred to operating room
• Nurse has an integral role to make sure that everything is in older for
safety of the patient

14. Perioperative care
• Perioperative care refers to the care rendered during pre-operative,
intra-operative and post-operative care of patients undergoing
surgery.
• A patient undergoes these three phases in different environments
and also experiences much stress and anxiety.
• The relationship between patient and nurse during these phases
significantly improves the outcome

15. Pre operative roles
• develop a good rapport with the patient
• explain about the intra-operative physical set-up, expectations,
personnel involved, anticipated events and timelines

16. Intra –operative roles
• Receive the patient in the receiving bay of operating room
• Remain with the patient and help in transporting the patient from the
receiving bay to the pre-anaesthesia room and assist in interventions
such as intravenous cannulation, shifting to operating room table,
catheterization and providing anesthesia.
• Communicate with other team members regarding any care
alterations

17. roles
• Has a knowledge of the operative procedure and
• the aims of the surgery
• Steps in the operative procedure
• Performs the count under supervision
• Aware of the instrumentation that will be used for
• the procedure
• Maintains the sterile field
• Assists with skin preparation and application of the
• drapes.