Modifi ed radical mastectomy sparing one or both pectoral muscles in the treatment of breast cancer: intra and postoperative complications

Abstract

CONTEXT AND OBJECTIVE: Modifi ed radical mastectomy is widely utilized in breast cancer treatment. However, no prospective compari- son has yet been made between the Madden technique (preservation of the pectoralis minor muscle) and the Patey technique (resection of this muscle). The aim of this work was to com- pare these two modifi ed radical mastectomy techniques, by analyzing their degrees of diffi culty and complications. DESIGN AND SETTING: Randomized trial at the Breast Unit of Hospital Araújo Jorge, Goiás; and Faculdade de Medicina da Universidade Federal de Goiás. METHODS: 430 patients with breast cancer with an indication for modifi ed radical mastectomy were included in the program, of whom 426 pa- tients were available for analysis (225 allocated to Patey and 201 to Madden). The chi-squared and Student t tests were used for analysis. RESULTS: The patients’ demographics were well balanced between the two groups. The mean duration of the surgical procedures was 105 (± 29.9) and 102 minutes (± 33), for the Patey and Madden groups, respectively (p = 0.6). Hospital- ization duration was 2.3 days for both groups. The mean number of lymph nodes resected was 20.3 (± 7.6) for Patey and 19.8 (± 8.1) for Madden (p = 0.5). There were no differences in terms of vascular or nerve sections, hematomas or infections. The surgeons reported the same degree of diffi culty for the two methods. CONCLUSION: The removal of the pectoralis minor muscle did not infl uence any of the vari- ables studied. Therefore, either technique can be performed, at the surgeon’s discretion.