Abstract
BackgroundBreast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer.MethodsA surgical technique using manual blunt dissection (MBD), in which use of electrocautery, an ultrasonically activated scalpel, and ligation is minimized, is described. This involves an approach from small incisions in the axilla or areola to avoid injury to skin flaps, and with adequate mobilization of the breast, so that regardless of the tumor site, surgical wounds are not noticeable. The usefulness and tolerability of this surgical technique were examined.ResultsThis surgical technique was evaluated in 233 patients. Surgery could be performed rapidly, with a mean operative time of 67 ± 21 min and a low mean blood loss of only 35 ± 28 ml. There was little need for postoperative analgesia, and surgery was well tolerated without postoperative bleeding or wound infection.ConclusionOur proposed technique for partial mastectomy using MBD provides good curative and cosmetic results.
Highlights
Breast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer
Surgical outcomes for 233 patients who underwent Bp + SNB at our hospital are shown. The indications for this surgery were a preoperative diagnosis of ductal carcinoma in situ (DCIS) or tumor size ≤3 cm for invasive carcinoma, each without clinical axillary node metastases [2]
Lesion extent was assessed by ultrasound and magnetic resonance imaging (MRI)
Summary
Breast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer. With the addition of appropriate postoperative radiotherapy, survival rates equivalent to mastectomy, low recurrence in the preserved breast, and acceptable treatment outcomes have been achieved [4,5,6]. New surgical techniques to maintain these cure rates and provide good cosmetic results must be developed. A surgical technique using manual blunt dissection (MBD), in which use of electro cautery, an ultrasonically activated scalpel, and ligation is minimized, is described. It involves an approach from small incisions in the axilla or areola to avoid injury to skin flaps, and with adequate mobilization of the breast, so that regardless of the tumor site, surgical wounds are not noticeable.
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