Toilet mastectomy continues to be a important adjunct to palliation in metastatic and locally advanced breast cancer.

1. Toilet mastectomy: A useful adjunct to palliativeToilet mastectomy: A useful adjunct to palliative
care in metastatic and locally advanced breastcare in metastatic and locally advanced breast
cancer patientscancer patients..
Dr.Ketan Vagholkar
MS,DNB,MRCS,FACS.
Consultant General Surgeon

2. Toilet mastectomy: A useful adjunct to palliativeToilet mastectomy: A useful adjunct to palliative
care in metastatic and locally advanced breastcare in metastatic and locally advanced breast
cancer patientscancer patients..
 Toilet mastectomy
continues to be a
excellent adjunct to
palliative care in
advanced breast cancer
patients.
 Local complications
such as bleeding and
secondary infection with
sloughing of the growth
are most distressful to
the patient.
 A well done toilet
mastectomy can
provide satisfactory
relief from these
complications.
 The response to
chemotherapy is also
quite better.

3. Salient features of toilet mastectomy.Salient features of toilet mastectomy.
 Wide excision taking into consideration the
limitations imposed by the paucity of
surrounding skin for closure.
 Reaching up to the muscle and in some cases
removing a part of the adherent muscle fibers.
 Avoid going into the axilla in view of adherent
lymph node masses engulfing the axillary
vessels.
 Rigorous intraoperative lavage with hypertonic
saline to destroy spilled cancer cells during
surgery.

4. Clinical CaseClinical Case
 68 year old lady with
locally advanced
breast cancer with
liver metastases and
local complications
of severe intermittent
bleeding from the
growth.

5. Specimen removed at toiletSpecimen removed at toilet
mastectomymastectomy
 The entire fungating
mass along with a
narrow rim of skin is
removed.
 The deep dissection
should extend upto
the underlying
pectoral muscles.

6. Final outcome of surgeryFinal outcome of surgery

7. Final outcome of surgeryFinal outcome of surgery