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At least 19 recordsLinked to original sources
PubMed1989

[Indications, technique, results and value of modified radical mastectomy].

Modified radical mastectomy is the most frequent operation performed for therapy of primary breast cancer. In T1 breast cancer patients the breast-conserving therapy is used in up to 40-60% of the patients. In T2 breast cancer patients modified radical mastectomy is still the most frequently used regimen (72-79%). Tumor, breast and psychological characteristics as well a technical facilities must be considered, when determining if modified radical mastectomy is indicated. The operation technique is presented.

Breast↗
PubMed2004

Granisetron and ondansetron for prevention of nausea and vomiting in patients undergoing modified radical mastectomy.

Modified radical mastectomy is associated with a relatively high incidence of postoperative nausea and vomiting (PONV). This study was undertaken to evaluate the comparative profile and efficacy of ondansetron and granisetron to prevent PONV after modified radical mastectomy. In a randomized, double-blind, placebo-controlled trial, sixty female patients received ondansetron 4 mg, granisetron 1 mg or saline intravenously just before induction of anaesthesia (n = 20 for each group). A standardized general anaesthetic technique was employed. The incidence of PONV and adverse events were recorded for the first 24h postoperatively. The incidence of PONV was 25% with ondansetron, 20% with granisetron and 70% with saline (P < 0.05, Chi-square test with Yates' correction factor). The incidence of adverse events was comparable among the groups. Ondansetron and granisetron are both effective for reducing the incidence of PONV in female patients undergoing modified radical mastectomy.

Adult↗
PubMed1981

[Preservation of the pectoral nerves in modified radical mastectomy].

Modified radical mastectomy with preservation of one or both pectoral muscles is the surgical treatment of choice in stage I and II breast cancer. A surgical anatomic study has been performed, based on post-mortem and intraoperative findings, to investigate origin and course of lateral and medial pectoral nerves and their relations to pectoral muscles and axillary lymphonodes. The results suggest that Patey-Meier operation can produce, in 80 per cent of cases, atrophy and fibrosis of the costoabdominal portion of the pectoralis major muscle as lateral pectoral nerve is generally dissected. On the contrary, radical mastectomy with both pectoral muscles preservation permit also to preserve the nerves during lymphadenectomy if they are recognized.

Atrophy↗
PubMed1977

[Radical mastectomy and modified radical mastectomy in the treatment of breast cancer. Indications and results].

We studied first the long term results in a series of 1 139 immediately operable breast cancers, treated by a protocol which gave an important role to extended radical mastectomy (radical mastectomy with internal mammary node dissection). No difference in survival was noted according to the surgical procedure used, and the extended mastectomy does not seem to have demonstrated its superiority. Its value could be judged in a more rigorous manner thanks to the results of an international therapeutic trial, comparing radical mastectomy with extended radical mastectomy. Results were improved by the extended procedure in only one sub-group of patients, whose tumours was located in central or inner quadrants, T1 or T2, with positive axillary nodes: these patients represents 13 per cent of patients with immediately operable tumors. Taking these results into account a new protocol has been adopted at the Institut Gustave-Roussy: T1 cancers will be the object of a therapeutic trial between conservative treatment and modified radical mastectomy. T2 (internal or central) cancers, with axillary nodal involvement will be treated by extended radical mastectomy. T2 tumors (external) and all T3 tumors will be treated by a modified radical mastectomy.

Breast Neoplasms↗
PubMed1983

A randomized prospective trial of radical (Halsted) mastectomy versus modified radical mastectomy in 311 breast cancer patients.

This study reports the results of a prospectively randomized trial for treatment of carcinoma of the breast comparing standard (Halsted) radical mastectomy to a modified radical mastectomy. Three hundred eleven patients with primary operable carcinoma of the breast were entered in a surgical and adjunctive chemotherapy trial in Alabama between 1975 and 1978. A total of 91 surgeons participated (all Diplomats of the American Board of Surgery and Members of the American College of Surgeons). All operative reports, pathology and therapy were reviewed by referees. Histologically node positive patients were randomized after operation to receive melphalan or C.M.F.(cytoxan, methotrexate, and 5-FU) for 1 year. After a median follow-up of 5.5 years, there was no significant difference in disease-free survival or in overall survival between the two groups. There was a trend toward improved 5-year survival rates in the radical mastectomy group compared to the modified radical mastectomy group (84% vs. 76%, p = 0.14). There was also an increased incidence of local wound recurrence in those patients receiving modified radical mastectomy, but the differences were not statistically significant (p = 0.09). Longer follow-up will be necessary to evaluate these results more fully.

Breast Neoplasms↗
PubMed1991

Glandular excision in total glandular mastectomy and modified radical mastectomy: a comparison.

Total glandular mastectomy and modified radical mastectomy were compared for the amount of breast tissue remaining after surgery. Multiple biopsies were taken from the anterior chest walls of women following total glandular mastectomy (N = 27) and modified radical mastectomy (N = 28) to try to detect any residual glandular tissue. Regardless of procedure performed, breast tissue was identified histologically in 5 percent of all biopsy specimens (159 and 161, respectively). One of every five operative fields was shown to have glandular elements in at least one of the biopsy sites; the positive biopsies did not form a discernible pattern. The residual breast tissue in each of these patients averaged less than 1 gm. On the basis of this study, modified radical mastectomy and total glandular mastectomy appear to be equally effective in removing most of the breast.

Biopsy↗
PubMedDate not supplied

Modified radical mastectomy: definition and role in breast cancer surgery.

The reasons for the dramatic change during the past decade in the United States regarding the surgical treatment of patients with potentially curable invasive breast cancers from the classical radical mastectomy to the modified radical mastectomy are discussed. The various types of modified radical mastectomy are described and the indications for their use as part of a moderate selective surgical approach to breast cancer are discussed in detail. The results obtained in 846 patients with potentially curable breast cancers who were followed for ten years or more are presented: 80.3% had less than a radical mastectomy including an absolute, no evidence of disease, survival rate of 63% and a local recurrence rate of 7.8%, along with ease of breast reconstruction when the pectoralis major muscle is preserved. These results, as compared to those obtained with other types of surgical approach and with primary radiotherapy, offer a most favorable comparison.

Breast Neoplasms↗
PubMed1992

One-day hospitalization following modified radical mastectomy.

Postoperative management of patients following modified radical mastectomy has changed dramatically in recent years. Historically, patients usually remained in the hospital with closed suction drainage until the amount of drainage had decreased sufficiently for them to be removed. The feasibility of early discharge on the day following surgery was studied in a prospective manner in 29 consecutive breast cancer patients; 27 underwent unilateral modified radical mastectomy and 2 bilateral mastectomies by a single surgeon. All patients were instructed before surgery about planned early discharge and drain care. Twenty-seven of 29 patients (93.3%) were discharged the day following surgery. However, 2 patients refused discharge and were discharged on postoperative Day Two, and one patient was readmitted for confusion. Drains were removed in the office an average of 5.07 days after surgery. Forty-five per cent of patients developed a seroma that required aspiration at least once. No significant long-term sequela were experienced as a result of early discharge. The average hospital cost was reduced by $2,474.00 or 36 per cent (P less than 0.001) as compared to other surgeons in the same medical center who held to traditional postoperative care. The authors conclude that discharge on the day following surgery for patients undergoing a modified radical mastectomy is safe and cost effective.

Adult↗
PubMed1979

A comparison of modified radical mastectomy to radical mastectomy in the treatment of operable breast cancer.

This study compares the results of modified radical mastectomy (144 cases) to radical mastectomy (188 cases) in the treatment of operable breast cancer. Two hundred five patients had Stage I breast cancer, 60 had Stage II disease and 67 had Stage III disease (TNM System). There was no statistically significant difference in five year survival when the results of a radical mastectomy were compared to a modified radical mastectomy at any stage of disease. There was no statistically significant difference in the incidence of local recurrence in patients with Stage I and Stage II disease when the results of a radical mastectomy were compared to modified radical mastectomy. Those patients with Stage III disease who were treated by a modified radical mastectomy had a statistically significant higher incidence of local recurrence (chest wall and axilla) in comparison to patients treated by radical mastectomy. We have concluded that a modified radical mastectomy is the treatment of choice in patients with Stage I and Stage II diseases. In patients with Stage III disease, a radical mastectomy provides a better chance of local control of the disease but offers no increased chance of survival.

Breast Neoplasms↗
PubMed1982

Rationale for immediate reconstruction of the breast following modified radical mastectomy.

In 62 patients in whom modified radical mastectomy was accompanied by immediate breast reconstruction, the operative and pathologic findings are compared to the clinical results. Immediate reconstruction following modified radical mastectomy appears to offer several advantages over delayed reconstruction. The data indicate that immediate reconstruction provides excellent technical results, is associated with less expense and morbidity as compared to delayed reconstruction, and does not adversely affect the natural course of the disease within the follow-up period studied. No adverse effect of adjuvant chemotherapy on the reconstructive effect was noted in this series of 62 patients when the initiation of adjuvant chemotherapy was timed so as to avoid difficulties with hemostasis. The technical aspects of the immediate reconstruction are described.

Adult↗
PubMed1990

[Modified radical mastectomy--an analysis of 217 cases].

Modified radical mastectomy (MRM) was performed in two hundred and seventeen patients with operable breast cancer during 1972-1982. Having been followed for 5 to 10 years, the results were compared with those of radical mastectomy (RM) during the same period. There was no significant difference in 5 and 10 year survival rates between the two groups. MRM had the advantages of insignificant deformity, better function and easy breast reconstruction in comparison with RM. The authors believe that MRM should be recommended as the treatment of choice for breast cancer.

Adenocarcinoma↗
PubMed1991

Preventing relapses of breast cancer with modified radical mastectomy.

Better prevention and early detection have improved the percentage of early cancers among all the treated breast tumors to about 40%. After the first demonstration in Milan in 1981 that even conservative surgery can effectively prevent tumor relapses, radical and modified radical mastectomy was compared in 136 and 127 women, respectively. The groups were well stratified as regards age, menopause, T- and N-status. No difference was found in 10-yr survival (58.8 and 59.8%, respectively) or local relapses (9.5 and 10%, respectively) or general relapses. The median disease-free survival was 10 yr in both groups. The results suggest that in T1-T2a, N0-N1b M0 unilateral breast cancer relapses are prevented as effectively with modified radical as with radical mastectomy.

Adult↗
PubMed2000

Modified radical mastectomy using harmonic scalpel.

BACKGROUND AND OBJECTIVES: Modified radical mastectomy (MRM) remains the most commonly performed surgery for breast cancer today. Conventional surgery using scalpel and electrocautery is associated with moderate blood loss and morbidity in the form of haematoma, flap necrosis, prolonged axillary drainage, and seroma. This study was performed to evaluate the feasibility of using ultrasonic energy (harmonic scalpel) for MRM and to standardise the operative technique of harmonic scalpel MRM using various available accessories of the harmonic scalpel. METHODS: Fourteen patients suffering from carcinoma breast planned for MRM were included in the study. RESULTS: The learning curve of harmonic scalpel MRM was short. Harmonic scalpel is a multifunctional instrument and the whole operative procedure could be accomplished with the currently available accessories. No sutures or electrocautery were used. The mean blood loss was 57.5 ml and the mean operative time was 117 min. There were no hematomas or flap necroses, whereas one patient developed seroma. The mean postoperative drainage volume was 430 ml. CONCLUSIONS: In comparison to the historical data of conventional mastectomy, there seems to be a reduction in the blood loss and drainage volume using harmonic scalpel. Results of our study show that modified radical mastectomy using the harmonic scalpel is feasible and the learning curve is short, however, further studies are needed to assess the impact on morbidity.

Breast Neoplasms↗
PubMed1975

Treatment of carcinoma of the breast by modified radical mastectomy.

To evaluate the results of treatment of Stage I and Stage II-T1 and T2, NO and N1-carcinoma of the breast by modified radical mastectomy with preservation of the pectoralis major muscle, the survival rates of all such patients treated by the senior author from 1965 through 1968 were compared with the survival rates of a simultaneous group of patients with similar stage disease treated by conventional radical mastectomy by the same surgeon. There were a total of 134 patients, of whom 51 had modified radical mastectomy and 83 conventional radical mastectomy. The five year survival rate for those treated by standard radical mastectomy was 81 per cent, and for those treated by modified radical mastectomy, it was 84 per cent. In patients with histologically negative axillary lymph nodes, the rates were 86 per cent following both radical mastectomy and modified radical mastectomy. Four per cent of the surviving patients after modified radical mastectomy and 7 per cent of the five year survivors after radical mastectomy had evidence of metastases at five years. Locally recurrent disease was noted in 5 per cent of those who had modified radical mastectomy and 7 per cent of those who underwent standard radical mastectomy. This analysis demonstrates that there is no significant difference in the survival and recurrence rates after conventional radical mastectomy and ,odified radical mastectomy of the Patey type. There is a high incidence of recurrence-free survival after both of these operations. Since modified radical mastectomy is less traumatic, involving less damage to muscular tissues, and is followed by significantly decreased deformity, it is advised as the treatment of choice for patients with carcinoma of the breast having no or minimal evidence of axillary node involvement. More extensive tumors adherent to the pectoral fascia or associated with multiple or large palpable axillary nodes should still be treated by conventional radical mastectomy.

Adult↗
PubMedDate not supplied

Lymphoedema of the arm after primary treatment of breast cancer.

The incidence of lymphoedema of the arm depends on the radical nature of the primary treatment-radical mastectomy modified radical mastectomy and breast-preserving operation. Adjuvant radiotherapy increased significantly the oedema rate of each operative modality. The quality of life could be improved by minimising the incidence of lymphoedema if current standards of breast-preserving surgery were generally practised.

Adult↗
PubMed2000

Role of increased arterial inflow in arm edema after modified radical mastectomy.

Chronic arm edema is a common finding after modified radical mastectomy and its pathophysiology is unclear. In a prospective study the value of increased arterial inflow and venous abnormalities after mastectomy was evaluated. Arterial and venous blood flow in axillary vessels of 39 patients with arm swelling and 16 patients without swelling were investigated by Doppler ultrasound. In patients with arm edema the arterial flow on the surgical treated side was 689.73+/-44.6 (mean+/-sem) ml/min and 427.73+/-30.8 ml/min on the contralateral side (p<0.05). In those without swelling the flow was 447.75+/-37.8 ml/min on the treated side and 354.95+/-28.7 ml/min on the contralateral side (p>0.05). The difference between arterial flow measurements on the treated sides of the patients with and without arm swelling was statistically significant. There was no significant difference between the measurements on the contralateral sides of both groups. Venous abnormalities were not detected in both groups of patients. We, therefore, conclude that modified radical mastectomy causes increased inflow in ipsilateral arm and it may play an important role in the etiology of arm swelling in breast cancer patients.

Adult↗
PubMed1981

Radical versus modified radical mastectomy for breast cancer.

A prospective randomised trial (534 patients, 1969-75) was designed to determine whether radical mastectomy conferred advantages over modified radical mastectomy for breast cancer in terms of total survival, local recurrence, distant metastasis, and disease-free interval. The results showed no significant difference in outcome as regards these variables between the two treatments.

Breast Neoplasms↗
PubMed1993

A comparison between scalpel and electrocautery in modified radical mastectomy.

OBJECTIVE: To compare the effects of a conventional cold scalpel and electrocautery in modified radical mastectomy. DESIGN: A non-randomised controlled trial. SETTING: Teaching hospital in Southern Taiwan. SUBJECTS: 101 consecutive patients with primary breast cancer who underwent modified radical mastectomy between July 1987 and June 1989. INTERVENTIONS: The 44 patients during the first year were allocated to have skin flaps fashioned conventionally with a cold scalpel and the 57 patients during the second year, by electrocautery. MAIN OUTCOME MEASURES: Morbidity and mortality among the 101 patients who underwent modified radical mastectomy. RESULTS: The groups were comparable in regard to age, menopause, cancer stage, weight of specimen and histological type of cancer. The mean blood loss was 567 ml when scalpel was used and 150 ml when electrocautery was used (p < 0.001). The postoperative fall in packed cell volume was significantly greater in the scalpel group (0.75 [0.26] compared with 0.28 [0.15], p < 0.001) and more patients in this group required transfusion (9 compared with 0, p < 0.01). There were no deaths in either group. There were no significant differences in operation time, total post-operative Hemovac drainage, postoperative hospital stay, the number of lymph nodes removed, the number of metastatic lymph nodes, and postoperative complications between the groups. CONCLUSION: Electrocautery is a safe, convenient and rational method for constructing skin flaps in modified radical mastectomy, and patients do not need blood transfusions.

Breast Neoplasms↗