What is a radical neck dissection? when is it done?

What is a radical neck dissection? The surgeon removes a block of tissue from the collarbone to the jaw and from the front to the back of the neck. The large muscle on the side of the neck that is used for rotating, flexing or extending the neck is also taken out, along with the major vein on the side of the neck. Sometimes, a less drastic operation, called a supraomohyoid neck dissection is done. This takes out only the lymph nodes, the tissue surrounding the nodes and a muscle at the front of the neck. Another technique, called a functional neck dissection, saves the muscles of the neck, taking out only the lymph nodes and tissues surrounding them.
What kind of incision is made with a radical neck dissection? The incision depends upon what the surgery is for. It can run from below the ear to the collarbone. Everything in the front of the neck on one side or on both sides may be removed. This may include the lymph nodes, blood vessels, nerves, and the salivary gland under the jawbone.

Why don't you tell me the biopsy results and then let me decide whether or not I want any further surgery or a removal of my breast?

As a general policy surgeons try to avoid cutting into a suspected cancer for biopsy without having the opportunity immediately to deal with the results of the biopsy. Each time a breast operation for a tumor is to be done, the surgeon discusses with the patient in advance the possibility that, if the biopsy indicates a cancer, the breast may have to be removed. Actually the patient usually gives written consent, in advance, for a breast amputation. Under very special circumstances, where the surgeon can be almost 100 percent certain that the mass is a benign tumor, he will remove it without discussing the possibility of the more radical procedure. This pertains, for example, to breast tumors in teen-age girls. These are so rarely cancerous that it is safe to go with this statistical experience.

What you're telling me then is that I will not know in advance, not until I wake up, whether or not my breast has been removed.

That's true.


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