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Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection
A L Vinton1, L W Traverso, P C Jolly
1Department of General Surgery, Virginia Mason Medical Center, Seattle, Washington.
American Journal of Surgery
|May 1, 1991
Summary
Tylectomy with axillary lymph node dissection and radiotherapy (TAD) showed fewer wound complications than modified radical mastectomy (MRM). Obesity was linked to infection in TAD, while age and smoking increased risks in MRM.
Area of Science:
- Surgical Oncology
- Breast Cancer Treatment
- Wound Complications
Background:
- Tylectomy with axillary lymph node dissection and radiotherapy (TAD) is an accepted treatment for early breast cancer.
- TAD offers comparable survival rates to modified radical mastectomy (MRM).
Purpose of the Study:
- To evaluate the safety of TAD concerning wound complications.
- To identify potential risk factors for wound complications in both TAD and MRM procedures.
Main Methods:
- Retrospective chart review of 560 patients (387 MRM, 173 TAD) from 1983-1989.
- Comparison of wound complication incidence (infection, seroma, hematoma, epidermolysis).
- Analysis of risk factors including obesity, age, smoking, antibiotics, and wound drainage volume.
Main Results:
- TAD group had significantly fewer wound complications (35%) than MRM group (49%).
- MRM group experienced higher rates of seroma (29% vs 18%) and epidermolysis (18% vs 0%).
- Risk factors identified: obesity (TAD infection), age ≥60 (MRM seroma), smoking (MRM epidermolysis), and high drainage volume (seroma in both groups).
Conclusions:
- TAD is a safer surgical option for early breast cancer regarding wound complications compared to MRM.
- Specific patient factors and wound drainage volume influence complication risk in both surgical approaches.