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Total mastectomy with complete axillary dissection

D F Roses, M N Harris, D A Potter

    Annals of Surgery
    |July 1, 1981
    PubMed
    Summary
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    This study presents a modified mastectomy technique for thorough axillary dissection. The approach preserves muscle innervation and cosmetic benefits, enhancing patient outcomes in breast cancer surgery.

    Area of Science:

    • Surgical Oncology
    • Breast Surgery
    • Anatomy

    Background:

    • Complete axillary dissection is crucial for breast cancer staging and treatment.
    • Traditional techniques can sometimes compromise cosmetic and functional outcomes.
    • The Patey operation is a standard approach for mastectomy with axillary dissection.

    Purpose of the Study:

    • To evaluate a modified total mastectomy technique with complete axillary dissection.
    • To assess the feasibility and benefits of preserving pectoralis major muscle innervation.
    • To maintain cosmetic and functional results comparable to the Patey operation.

    Main Methods:

    • The technique involves dividing the sternal portion of the pectoralis major muscle insertion.
    • Innervation of the pectoralis major is preserved throughout the procedure.

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  • Resection of the pectoralis minor muscle is performed after dissection.
  • Reconstruction follows the completion of axillary dissection and resection.
  • The modified technique was applied in 115 consecutive procedures.

    • Main Results:

    • The modified technique facilitated thorough axillary dissection in all cases.
    • Preservation of pectoralis major innervation was achieved.
    • Cosmetic and functional outcomes were maintained.
    • No major complications were reported related to the modification.

    Conclusions:

    • This modified mastectomy technique allows for complete axillary dissection while preserving key anatomical structures.
    • The approach offers a favorable balance between oncologic clearance and functional/cosmetic preservation.
    • This technique represents a valuable option for breast cancer surgery requiring axillary lymph node assessment.