Mastectomy total

Fisher B, Jeong JH, Anderson S, et al. Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med 2002 347 567— 575. 

Simple or total mastectomy involves removal of the entire breast without dissection of underlying muscle or axillary nodes. This procedure is used for carcinoma in situ where the incidence of axillary node involvement is only 1% or with local recurrence following breast conservation therapy. 

L., Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N. Engl. J. Med. 320,822-828 (1989). 

A 60-year-old female with a history of breast carcinoma treated by mastectomy three years previously is now complaining of general malaise and bone pain. Biochemistry showed that lluid and electrolytes, total protein, albumin and calcium values were all normal. LFTs were as follows ... 

A 79-year-old woman with a long history of bipolar disorder, stabilised on lithium carbonate and doxepin 200 mg at bedtime and also taking propranolol, was given tamoxifen 20 mg daily after a mastectomy for breast cancer. It was noted that her total blood levels of doxepin and its major metabolite were reduced by about 25% over the next 11 months. The control of her depression remained unchanged. The reasons for this apparent interaction are not known. The manufacturer of tamoxifen has another undetailed and isolated report of a possible interaction. ... 

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