All the following structures are preserved in modified radical mastectomy except ?
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Correct Answer:
Intercostobrachial N
Description:
Ans. is 'b' i.e., Intercostobrachial N. o The nerve to latissimus dorsi and the nerve to senstive anterior are identified and preserved,o The upper branches of asillaiy artery and companion veins are usually sacrificed,o The intercostobrachial nerve is divided as it emerges from the second rib space.Let's see the nomenclature of various surgeries on breasto Simple or Total mastectomyIt removes all breast tissue, the nipple-areola complex, and skin.o Extended simple mastectomySimple mastectomy + removal of level I axillary lymph nodes.o Modified radical mastectomyIt removes all breast tissue, the nipple-areola complex, skin and the level I and level II axillary lymph nodes.o Halstead's Radical mastectomyRemoves all breast tissue and skin, the nipple areola complex, the pectoralis major and minor muscles and the level I, II and III axillary? lymph nodes.Modified Radical Mastectomyo Two forms of modified radical mastectomy are in useAuchincloss (pronounced as 'aushinclossj procedureHere both the pectoralis major and minor muscles are presented with removal of level / and II axillary lymph nodes.o Patey's ProcedureHere the pectoralis minor muscle is removed to allow complete dissection of level III axillary lymph nodes.o Scanlon's modification of Patey's procedureHere the pectoralis minor muscle is divided instead of removing. Division of pectoralis minor muscle allows complete removal of level III lymph nodes.Halstead Radical Mastectomyo In this operation following structures are removed.The whole breastThe portion of skin overlying the tumor, which includes the nipple-areola complex.The subcutaneous fat and the deep fascia vertically from the lower border of the clavicle upto the upper quarter of the sheath of the rectus abdominis and horizontally from the strenum to the anterior border of lattissimus dorsi.Pectoralis maj or muscl ePectoralis minor muscle and clavipectoral fasciaUpper part of the aponeurosis of the external oblique and anterior parts of a few digitations of the serratus anterior muscleAll fatty and loose areolar tissue along with level I, II & 111 axillary lymph nodeso Structures saved are :The axillary- vein and the cephalic veinThe long thoracic nerve of Bell (Nerve to serratus anterior). The nerve to latissimus dorsi may be sacrified if required.Also knowo Extended Radical Mastectomy - Radical mastectomy + removal of internal mammary' lymph nodes.o Super Radical Mastectomy - Radical mastectomy + removal of internal mammary mediastinal and supraclavicular lymph nodes.
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