The authors declare that they have no competing interests.
All authors were involved in the preparation of this manuscript. SK participated in the design of the study and drafted the manuscript. NO helped with data collection and manuscript preparation. YA, KK, TM, and SN helped with study data collection and participated in its design. HK and TT helped with data collection and manuscript preparation. SK and KH conceived the study, and participated in its design and coordination and helped to draft the manuscript. All authors have read and approved the final manuscript.
Breast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer.
A 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.
This 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.
Our proposed technique for partial mastectomy using MBD provides good curative and cosmetic results.
Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366(9503):2087–106.
Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. NEngl J Med. 2002; 347(16):1227–32. CrossRef
Harris JR, Levene MB, Svensson G, Hellman S. Analysi of cosmetic results following primary radiation therapy for stage I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys. 1983;52:442–5.
Houvenaeghel G, Nos C, Mignotte H, Classe JM, Giard S, Rouanet P, Lorca FP, Jacquemier J, Bardou VJ. Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer: Micrometastases in sentinel lymph node in a multicentric study: predictive factors of nonsentinel lymph node involvement--Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer. J Clin Oncol. 2006;24:1814-22.
Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsyand lymphatic mapping of patients with breast cancer. Ann Surg. 1998;227(5):645-653.
Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al: The sentinel node in breast cancer--a multicenter validation study. N Engl J Med. 1998; 339(14):941-46.
Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoidaxillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997; 349(9069):1864-67.
Takeda M, Ishida T, Ohnuki K, Suzuki A, Kiyohara H, Moriya T, et al. Breast conserving surgery with primary volume replacement using a lateral tissue flap. Breast Cancer. 2005; 12(1):16-20.
Kashiwagi S, Onoda N, Takashima T, Asano Y, Aomatsu N, Nakamura N, et al. Breast Conserving Surgery and Sentinel Lymph Node Biopsy under Local Anesthesia for Breast Cancer. J Cancer Ther. 2012; 3:810–813. CrossRef
- Partial mastectomy using manual blunt dissection (MBD) in early breast cancer
- BioMed Central
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