scholarly journals Role of flap fixation during modified radical mastectomy in locally advanced breast carcinoma patients: a randomised control study

2019 ◽  
Vol 6 (12) ◽  
pp. 4465
Author(s):  
Raghavendra R. T. ◽  
Sushanto Neogi
Keyword(s):  
Breast Carcinoma ◽  
Locally Advanced ◽  
Test Group ◽  
Radical Mastectomy ◽  
Control Group ◽  
Skin Flaps ◽  
Modified Radical Mastectomy ◽  
Fixation Technique ◽  
Flap Fixation ◽  
Clinically Significant

Background: Treatment of locally advanced breast carcinoma (LABC) patients involves multimodal approach. Modified radical mastectomy (MRM) is preferred in them. Seroma and prolonged drainage are most common post-op complications. This study was conducted to evaluate the effect Flap fixation technique in reducing drain output and seroma in patients with LABC.Methods: 30 stage III breast cancer patients undergoing MRM were included. Prior to skin closure patients were randomised into: test (15) and control group (15). In Test group, skin flaps were sutured to chest wall with vicryl 3-0 at 3 cm intervals and skin was closed with nylon. In conventional group, only skin was closed with nylon sutures. In both the groups conventional closed suction drains were placed. Total drain output, clinically significant seroma, post-operative complications were compared between the two groups.Results: Total drain output in test group (4445 ml) was lesser compared to control group (4801 ml) but not statistically significant (p=0.548), however the percentage reduction of drain output on day 2 was significantly higher in test group (42%) as compared to control group (31.8%) (p=0.04). The clinically significant Seroma formation rates were similar in both groups but the volume of seroma aspirated was significantly lower in test group (p<0.05).Conclusions: The flap fixation technique group had better approximation of skin flaps and chest wall, as evident with reduction of drain output, significant reduction in drain output on post op day 2 and reduction of seroma volume.

scholarly journals Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Dhanya Vasudevan ◽  
P. S. Jayalakshmy ◽  
Suresh Kumar ◽  
Siji Mathew
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Tumor Characteristics ◽  
Modified Radical Mastectomy ◽  
Tumor Bed

Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT) in the setting of locally advanced breast cancer (LABC) can render inoperable tumor (T4, N2/N3) resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response.Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48) were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR).Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms) and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed.Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

scholarly journals Randomized Controlled Trial of Modified Radical Mastectomy with and Without Quilting Technique and Its Effect on Seroma Formation

2021 ◽  
pp. 1-4
Author(s):  
Munazzah Aziz ◽  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Randomized Controlled ◽  
Group I ◽  
Flap Fixation ◽  
Group Ii

Objective: To determine the frequency of seroma formation after flap fixation by quilting technique in MRM patients as compared to control group. Study Design: Randomized controlled trial. Place and Duration of study: This study was conducted from 11th November ,2017 to 10th May , 2018 in Department of Surgery, Holy family Hospital, Rawalpindi. Patients and Method: A total of 60 patients were included in the study having histologically proven breast cancer stage 2 or 3 in age group of 40-70 years undergoing modified radical mastectomy. Patients were allocated to group1 or 2 by random selection. In group I patients, flap fixation was done by quilting technique during MRM . In group II , no quilting was done. Post operative follow up was done after 05 days in OPD and development of seroma was observed clinically. Results: Mean age of patients was 55.23 ± 7.94 years. Mean BMI was 30.05 ± 2.63 kg/m2. Seroma formation was seen in 04 patients (13.33%) in group I (flap fixation by quilting technique ) and 19 patients (63.33%) in group II (control group) with p-value of 0.0001. Conclusion: This study concluded that there is significantly low incidence of post mastectomy seroma formation in MRM patients with quilting technique as compared to the conventional method of wound closure in MRM

scholarly journals Comparison of frequency of seroma formation in flap fixation versus conventional closure after modified radical mastectomy.

2020 ◽  
Vol 27 (05) ◽  
pp. 907-909
Author(s):  
Muhammad Dilawaiz Mujahid ◽  
Muneeza Zubair ◽  
Tayyab Ahsan Tanvir ◽  
Jaweria Masood
Keyword(s):  
Subcutaneous Tissue ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
Common Source ◽  
Modified Radical Mastectomy ◽  
Fixation Technique ◽  
Flap Fixation ◽  
Randomized Control ◽  
Hospital Ethics ◽  
Trial Setting

Seroma formation is a known complication after any surgery where excessive dissection of subcutaneous tissue leads to disruption of lymphatic channels. Seroma formation, its sequelae and frequent visits to doctor for their management are a common source of discomfort for patients. Objectives: Comparison of frequency of seroma formation after flap fixation versus convetional closure after modified radical mastectomy. Study Design: Randomized control trial. Setting: Department of Surgery, Allied Hospital Faisalabad. Period: 6 months from May 1, 2016 to October 31, 2016. Material & Methods: After permission from Hospital ethics committee and informed consent from patients, 70 patients were randomly divided into two groups (35 participants in each group). Findings were noted and data was analyzed statistically. Results: It was observed that incidence of seroma formation following modified radical mastectomy was lower with flap fixation technique (14.29%) as compared to conventional closure of wound margins (42.86%). Conclusion: Flap fixation technique is better approach compared to conventional method to prevent seroma formation.

scholarly journals The utility of pectoral drain in patients undergoing modified radical mastectomy-an observational study

2017 ◽  
Vol 4 (7) ◽  
pp. 2181
Author(s):  
Yogesh Kumar ◽  
Ashok Kumar ◽  
Vineet Singh ◽  
Shobha Pakhriya
Keyword(s):  
Breast Cancer ◽  
Developing Countries ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Potential Space ◽  
Skin Flaps ◽  
Modified Radical Mastectomy ◽  
Advanced Stages ◽  
Axillary Drain ◽  
A Prospective Study

Background: Breast cancer is one of the most common malignancies in female and in developing countries majority of them present in locally advanced stages. Modified radical mastectomy (MRM) is the main surgical management & axillary drain is deployed to tackle the leaking axillary lymphatics. However, if at all the pectoral area between the skin flaps and pectoral muscles requires drainage can be contested since the skin flaps are snugly approximated to the chest wall obliterating any potential space. The study is conducted to evaluate the output of pectoral drain & axillary drain in patients of MRM.Methods: This is a prospective study of 120 consecutive patients over a 2-years period who presented with breast cancer and undergone MRM in a teaching hospital. Two separate drains equal in all parameters were inserted in axilla and pectoral area and the collection in these drains studied post operatively.Results: The contribution of pectoral drain to total drain output was only 7.97%, while the axillary drain contribution was 92.03% in total drain output. So, the contribution from the pectoral drain was statistically insignificant (p=<0.001).Conclusions: MRM can be performed without drainage at the pectoral area.

Comparison of Outcome of one Versus two Drains Insertion for Seroma Formation Following Modified Radical Mastectomy in Breast Carcinoma

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Shiraz Shaikh ◽  
Ambreen Munir ◽  
Shahnawaz Abro ◽  
Shahida Khatoon ◽  
Zameer Hussain Laghari ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
General Surgery ◽  
Stable Condition ◽  
Radical Mastectomy ◽  
Seroma Formation ◽  
University Hospital ◽  
P Value ◽  
Modified Radical Mastectomy ◽  
Group A ◽  
Group B

Objective: Comparative outcome of one versus two drains insertion for in the term of seroma formation following modified radical mastectomy in breast carcinoma. Methodology: This Prospective Interventional trial was conducted at Department of General Surgery, Liaquat University Hospital Hyderabad from February 2018 to January 2019.  Females with breast carcinoma admitted for modified radical mastectomy were included. Patients were divided into two groups.  Groups I underwent one drain placement and group II underwent two drains placement. All patients were observed to measure and record the volume of the fluid. Patients were discharged from Hospital in stable condition and after removal of drains, and followed up weekly for one month. Data was recorded on self-made proforma and analyzed by using SPSS-20. Results: Total of 80 patients were selected, 38 in group A and 42 in group B. Mean age of patients of group A was 49.08 ± 9.89 years and group B was 51.40 ± 13.59 years. , Excised Mass weight was lesser in group A as compared to group B. Mean volume of drain discharge was significantly higher in Group B 323.43 ± 158.88 ml, while it was in group A 230.29± 200.98, findings were statistically significant 0.013. Seroma formation was statistically insignificant among both groups as 8(21.1%) in group A and   10(23.8%) in group B, p-value 0.768. Conclusion: One-drain and two-drain insertion are equally effective to reduce the seroma formation after modified radical mastectomy; however, one drain insertion leads to more patient compliance and comfort with probably less morbidity and cost.

scholarly journals Comparison of the Effectiveness of Full Negative Pressure with Half Negative Pressure on Suction Drain in Reducing Post-Modified Radical Mastectomy Seroma

2019 ◽  
Vol 2 (2) ◽  
pp. 24-31
Author(s):  
Gulraj Singh ◽  
Mulawan Umar ◽  
Nur Qodir
Keyword(s):  
Breast Cancer ◽  
Negative Pressure ◽  
Radical Mastectomy ◽  
Control Group ◽  
Breast Cancer Patients ◽  
Modified Radical Mastectomy ◽  
Pressure Groups ◽  
Suction Drain ◽  
Significant Difference ◽  
June July

Abstract Introduction: Modified radical mastectomy (MRM) is a breast cancer treatment option that is still operable. One of the postoperative complications that can be found is the formation of seroma. High negative suction drain is done to treat seroma after surgery but it can contribute to increase the length of stay in hospital. Methods: This study was a clinical randomized control trial (cRCT) conducted on 30 breast cancer patients in June - July 2019 at Moehammad Hoesin Hospital in Palembang. This study divided the two sample groups, each group consisting of 15 patients. One group was given half negative pressure on suction drain (experimental group) and the other used full negative pressure on suction drain (control group). Results: There was a significant difference (p <0.005) between the full and half negative pressure groups where there were more seroma events in the full vacuum group in 9 (60%) cases and half vacuum in 2 (30%) but there were no significant differences in long period of stay (p> 0.005). Conclusion: Half negative pressure is more effective in treating seroma than full negative pressure.

scholarly journals Prospective Study: The Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block versus Serratus Plane Block in Patients Undergoing Modified Radical Mastectomy

2021 ◽  
pp. 9-18
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader
Keyword(s):  
Radical Mastectomy ◽  
Analgesic Efficacy ◽  
Erector Spinae ◽  
Control Group ◽  
Modified Radical Mastectomy ◽  
Ultrasound Guided ◽  
Serratus Anterior ◽  
Group Iii ◽  
Erector Spinae Plane Block ◽  
Group I

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.

scholarly journals Immunohistochemistry profile and its relation with prognosis in locally advanced breast cancer

2019 ◽  
Vol 6 (12) ◽  
pp. 4507
Author(s):  
Naseef Kannanavil ◽  
Nabeel Thommil Padinjarenalakath ◽  
Ahsan Vilayapoyilil ◽  
Abidali Karatparambil
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Response To Therapy ◽  
Advanced Breast ◽  
Age Group ◽  
Modified Radical Mastectomy ◽  
Number Of Patients ◽  
Related Mortality

Background: Breast cancer is one of the most common malignancy and leading cause of cancer related deaths in women worldwide. Immunohistochemistry (IHC) is done to characterize intracellular proteins or cell-surface antigens and is used to assess tumour subtypes, confirm diagnosis, predict prognosis and response to therapy. The aim of the present study was to evaluate the relationship of IHC profile- ER, PR and HER2 neu and prognosis of patients who underwent modified radical mastectomy for locally advanced breast cancer.Methods: A retrospective cohort study was conducted at MES Medical College Hospital from October 2015 to November 2017 in patients who underwent modified radical mastectomy for locally advanced breast carcinoma. A total of 65 women were enrolled in the study. 5 years survival was taken as the prognostic indicator.Results: Majority of the patients belong to the age group of 40-49 years with 40% patients followed by 33.84% patients in the age group of 50-59 years. Maximum number of patients was found in 2B stage of tumour. Maximum patients belonged to the ER/PR+, HER2- subgroup (27), followed by triple negative (ER/PR-, HER2) subgroup (16). There was no disease related mortality in ER/PR+, HER2+ and ER/PR+, HER2- subgroups. There were 1 and 2 disease related mortality in ER/PR-, HER2+ and triple negative subgroups respectively.Conclusions: In the present study the worst prognosis was observed in triple negative (ER/PR-,HER2-) IHC subgroup followed by the HER2 enriched (ER/PR-, HER2+) subgroup. 

Sign in / Sign up

Export Citation Format

Share Document