In a female patient modified radical mastectomy has been done. Which of the following organs can be removed in this type of surgery?

Appeared in: NORCET 3 - 2022 (Shift-2)

Explanation

A modified radical mastectomy (MRM) is a comprehensive surgical procedure for treating invasive breast cancer.
It involves the removal of the entire breast mound, which includes all breast tissue, the nipple, and the areola (the nipple-areola complex).
Additionally, a significant number of axillary lymph nodes (typically levels I and II) are also dissected and removed to check for cancer spread.
Since the procedure removes the areola, nipple, and breast tissue, the option 'All of above' is the correct and most complete answer.

Option A: This is an incomplete answer. While the areola is removed as part of the nipple-areola complex, the surgery is much more extensive, also removing the nipple, all breast tissue, and axillary lymph nodes.
Option B: This is also an incomplete answer. The nipple is removed, but this does not describe the full scope of the procedure, which includes the areola, breast tissue, and lymph nodes.
Option C: This is an incomplete answer. The procedure removes the entire breast, which includes the overlying skin and the nipple-areola complex, not just the internal glandular tissue.

Clinical Relevance

Nursing practice connection: Use the key finding related to Surgical Management of Breast Cancer: Modified Radical Mastectomy to guide bedside assessment, documentation, and the next nursing action.
Post-mastectomy nursing care is critical to prevent complications. The highest priority is protecting the affected arm from lymphedema by strictly avoiding blood pressure measurements, IV insertions, and blood draws on that side.
Nurses must educate patients on managing surgical drains (like Jackson-Pratt), performing arm exercises to regain mobility, and recognizing signs of infection or seroma.
Psychological support is a key nursing role, as patients cope with changes in body image and a cancer diagnosis.

How to Approach the Question

First, identify the key term in the question: 'modified radical mastectomy'.
Recall the definition of this specific surgical procedure. What anatomical structures does it involve removing?
Systematically evaluate each option. Is the 'Areola' removed? Yes. Is the 'Nipple' removed? Yes. Is the 'Breast Tissue' removed? Yes.
Recognize that options A, B, and C are all correct components of the procedure.
Conclude that the most comprehensive and correct choice is the one that encompasses all the others, which is 'All of above'.

Concept Tested & Keywords

Concept Tested: Surgical Management of Breast Cancer: Modified Radical Mastectomy
Stem keywords: modified radical mastectomy, female patient, organs removed
Lead-in keywords: Which of the following
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 51-53

E6 Midwifery Obstetrics and Gynecology Nursing Sandeep Kaur p. 14-20

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Attempt every question from this paper in a timed mock, then review the full solution for each one.