General Surgery · Breast

Modified Radical Mastectomy

OPERATION: Modified Radical Mastectomy (MRM)
ANAESTHETIC: General orotracheal anaesthesia
ANTIBIOTICS: IV prophylaxis at induction. VTE prophylaxis with sequential compression devices.
POSITION: Supine, arms extended on arm boards at approximately 90°. Ipsilateral operative arm prepped into field.

INDICATION:
Invasive breast carcinoma — breast conservation contraindicated or patient preference for mastectomy. [Indications for modified radical mastectomy rather than simple mastectomy: clinically node-positive axilla / positive SLNB requiring ALND / tumour characteristics indicating high nodal risk]. Confirmed by core biopsy. Preoperative assessment: mammogram, USS, MRI. Side and site confirmed and marked pre-operatively.

PROCEDURE:
WHO Checklist performed. Correct side confirmed. Breast and axilla prepared and draped — tumescent solution (1 L lactated Ringer's with 30 ml 1% lidocaine with adrenaline 1:1000) infiltrated subcutaneously into breast and axilla.