Breast surgery is a form of surgery performed on the

breast The breast is one of two prominences located on the upper ventral region of a primate's torso. Both females and males develop breasts from the same embryological tissues. In females, it serves as the mammary gland, which produces and secret ...

Types

Types include: *

Breast reduction surgery Reduction mammoplasty (also breast reduction and reduction mammaplasty) is the plastic surgery procedure for reducing the size of large breasts. In a breast reduction surgery for re-establishing a functional bust that is proportionate to the wom ...

Augmentation mammoplasty Breast augmentation and augmentation mammoplasty is a cosmetic surgery technique using breast-implants and fat-graft mammoplasty techniques to increase the size, change the shape, and alter the texture of the breasts. Augmentation mammoplasty is ...

* Mastectomy *

Lumpectomy Lumpectomy (sometimes known as a tylectomy, partial mastectomy, breast segmental resection or breast wide local excision) is a surgical removal of a discrete portion or "lump" of breast tissue, usually in the treatment of a malignant tumor or brea ...

Breast-conserving surgery Breast-conserving surgery (BCS) refers to an operation that aims to remove breast cancer while avoiding a mastectomy. Different forms of this operation include: lumpectomy (tylectomy), wide local excision, segmental resection, and quadrant ...

, a less radical cancer surgery than mastectomy *

Mastopexy Mastopexy (Greek μαστός ''mastos'' "breast" + -pēxiā "affix") is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman, by changing and modifying the size, contour, and elevation of the breasts. ...

, or breast lift surgery * Surgery for

breast abscess Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs ...

, including incision and drainage as well as excision of lactiferous ducts * Surgical

breast biopsy A breast biopsy is usually done after a suspicious lesion is discovered on either mammography or ultrasound to get tissue for pathological diagnosis. Several methods for a breast biopsy now exist. The most appropriate method of biopsy for a patien ...

* Microdochectomy (removal of a lactiferous duct)

Complications

After surgical intervention to the breast, complications may arise related to

wound healing Wound healing refers to a living organism's replacement of destroyed or damaged tissue by newly produced tissue. In undamaged skin, the epidermis (surface, epithelial layer) and dermis (deeper, connective layer) form a protective barrier agains ...

. As in other types of surgery, hematoma (post-operative bleeding),

seroma A seroma is a pocket of clear serous fluid (filtered blood plasma). They may sometimes develop in the body after surgery, particularly after breast surgery, abdominal surgery, and reconstructive surgery. They can be diagnosed by physical signs, ...

(fluid accumulation), or incision-site breakdown (wound infection) may occur.

Breast hematoma Breast hematoma is a collection of blood within the breast. It arises from internal bleeding (hemorrhage) and may arise due to trauma (breast injury or surgery) or due to a non-traumatic cause. Symptoms Symptoms may include visible discoloring ...

due to an operation will normally resolve with time but should be followed up with more detailed evaluation if it does not.

Breast abscess Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs ...

can occur as post-surgical complication, for example after cancer treatment or reduction mammaplasty.Noel Weidner, Chapter ''Infections of the breast'' (pp. 34–43). In: Furthermore, if a breast has already undergone irradiation (as in radiation therapy for treating breast cancer), there is a heightened risk of complications (e.g. reactive inflammation, occurrence of a chronic draining wound, etc.) for breast biopsies or other interventions to the breast, even those often considered "minor" surgeries. The combined effects of radiation and breast cancer surgery can in particular lead to complications such as breast

fibrosis Fibrosis, also known as fibrotic scarring, is a pathological wound healing in which connective tissue replaces normal parenchymal tissue to the extent that it goes unchecked, leading to considerable tissue remodelling and the formation of perma ...

, secondary

lymphoedema Lymphedema, also known as lymphoedema and lymphatic edema, is a condition of localized swelling caused by a compromised lymphatic system. The lymphatic system functions as a critical portion of the body's immune system and returns interstitial ...

(which may occur in the arm, the breast or the chest, in particular after

axillary lymph node The axillary lymph nodes or armpit lymph nodes are lymph nodes in the human armpit. Between 20 and 49 in number, they drain lymph vessels from the lateral quadrants of the breast, the superficial lymph vessels from thin walls of the chest and the ...

dissection), breast asymmetry, and chronic/recurrent breast

cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of th ...

, each of these having long-term effects. Ultrasound can be used to distinguish between seroma, hematoma, and edema in the breast. Further possible complications are

fat necrosis Fat necrosis is a form of necrosis characterized by the action upon fat by digestive enzymes. In fat necrosis the enzyme lipase releases fatty acids from triglycerides. The fatty acids then complex with calcium to form soaps. These soaps appea ...

(premature cell death of fat cells) and scar retraction (shrinking of the area around the surgical scar). In rare cases after breast reconstruction or augmentation, late seroma may occur, defined as seroma occurring more than 12 months postoperatively. There is preliminary evidence suggesting that

negative-pressure wound therapy Negative-pressure wound therapy (NPWT), also known as a vacuum assisted closure (VAC), is a therapeutic technique using a suction pump, tubing and a dressing to remove excess exudate and promote healing in acute or chronic wounds and second- a ...

may be useful in healing complicated breast wounds resulting from surgery. Postoperative pain is common following breast surgery. The incidence of poorly controlled acute postoperative pain following breast cancer surgery ranges between 14.0% to 54.1%.

Regional anaesthesia Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It ...

is superior compared to

general anaesthesia General anaesthesia (UK) or general anesthesia (US) is a medically induced loss of consciousness that renders the patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general ...

for the prevention of persistent postoperative pain three to 12 months after breast cancer surgery. In post-surgical medical imaging, many findings can easily be mistaken for cancer.Postsurgical breast imaging
Medscape, last updated 11 November 2013 In MRI, scars that occurred many years before are normally "silent".

References

{{Breast procedures