Modified radical mastectomy sparing one or both pectoral muscles in the treatment of breast cancer: intra and postoperative complications.
OBJECTIVE
Modified radical mastectomy is widely utilized in breast cancer treatment. However, no prospective comparison 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 compare these two modified radical mastectomy techniques, by analyzing their degrees of difficulty and complications.


METHODS
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 modified radical mastectomy were included in the program, of whom 426 patients 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). Hospitalization 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 difficulty for the two methods.


CONCLUSIONS
The removal of the pectoralis minor muscle did not influence any of the variables studied. Therefore, either technique can be performed, at the surgeon's discretion.
Freitas-Júnior
Ruffo
R
Breast Unit of Hospital Araújo Jorge, Associação de Combate ao Câncer em Goiás, Department of Gynecology and Obstetrics, Faculdade de Medicina, Universidade Federal de Goiás. ruffojr@terra.com.br
Oliveira
Evelling Lorena Cerqueira
EL
Pereira
Rubens José
RJ
Silva
Marco Aurélio Costa
MA
Esperidião
Maurício Duarte
MD
Zampronha
Rossana Araújo Catão
RA
Ribeiro
Luiz Fernando Jubé
LF
Queiroz
Geraldo Silva
GS
Jorge
Estanislau Araújo
EA
Rahal
Rosemar Macedo Sousa
RM
Ferro
Júlio Eduardo
JE
Paulinelli
Régis Resende
RR
Barbosa
Silvânia Fátima Coelho
SF
D001365:Axilla / Q000601:surgery; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D015411:Mastectomy, Modified Radical / Q000379:methods* / Q000592:standards; D008875:Middle Aged; D009367:Neoplasm Staging; D010369:Pectoralis Muscles / Q000601:surgery*; D011183:Postoperative Complications