Abstract
Abstract Background: In recent years, surgeons have utilized Harmonic instruments to perform breast cancer resection. Retrospective and prospective studies have demonstrated that the use of this surgical device for mastectomy and axillary dissection can reduce perioperative blood loss, seroma formation, and duration and total amount of drainage. No study has analyzed the feasibility of Harmonic instruments in breast-conserving surgery. We conducted a prospective, randomized clinical trial comparing Harmonic instrument and conventional surgery in the performance of breast conserving surgery and axillary procedures to determine differences in surgical procedures, postoperative outcome, and complications. Methods: One hundred and forty seven patients with operable breast cancer who underwent breast-conserving surgery at a single institution between December 2009 and March 2011 were included in the analysis. Surgery was performed in 73 patients with the Harmonic Focus® device and in 74 with scissors and electrocautery. Charts were reviewed for patient demographics, histopathologic reports, surgical procedures, length of stay, volume and duration of postoperative drainage, complications such as seroma and hematoma formation, and postoperative pain. Results: We found a statistically significant difference in size of resected breast tissue (p<0.001), postoperative serum hemoglobin (p=0.001), volume (p<0.001) and duration (p<0.001) of breast drainage, volume (p<0.001) and duration (p=0.001) of axillary drainage, intramammary (p=0.04) and axillary (p=0.006) seroma formation, subjective (p=0.012) and objective (p<0.001) postoperative pain, and length of hospital stay (p=0.002) in favor of the Harmonic surgical device. Discussion: This is the only study comparing the Harmonic instrument with traditional surgery in both breast conserving surgery and axillary procedures. From this study, we conclude that despite higher costs, the Harmonic device is safe to use and provides key benefits in intraoperative technique, postoperative outcome, and rate of complications in breast cancer surgery. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-15-09.
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