Effect of different surgical approaches on tumor control and safety after modified radical mastectomy for breast cancer

ObjectiveTo analyze the effects of different surgical approaches on tumor control and safety after modified radical mastectomy.

MethodsA total of 106 breast cancer patients scheduled by modified radical mastectomy for breast cancer were randomly divided into the group A and group B(53 cases in each group).The group A was treated with anterior ectopectoralis approach, and the group B was treated with posterior ectopectoralis approach.The perioperative indicators(including operation time, drainage time, hospital stay, intraoperative blood loss, total drainage volume and lymph node dissection time), complications and quality of life were compared between two groups.Two groups were followed up for 5 to 29 months, and the local recurrence, distant transfer and survival in two groups were observed.

ResultsThe operative time, intraoperative blood loss, lymph node dissection time, drainage time, total drainage volume and length of hospital stay in group A were significantly lower than those in group B(P < 0.01).There was no statistical significance in the incidence rates of subcutaneous effusion, skin flap necrosis and upper limb edema between two groups(P>0.05).The incidence rates of severe pectoralis major atrophy and sensory disturbance in axilla and upper medial arm in group A were significantly lower than those in group B(P < 0.01).The scores of physical, psychological, social support and spiritual quality of life in group A after 8 weeks of operation were significantly higher than those in group B(P < 0.01).All patients were followed up for (19.47±4.56) months.There was no statistical significance in the rates of axillary lymph node recurrence, suclavicular lymph node metastasis, distant lymph node metastasis and overall survival between two groups(P>0.05).

ConclusionsModified radical mastectomy through the anterior ectopectoralis approach can reduce the intraoperative trauma and postoperative complications and improve the quality of life, and its effects on the tumor control is not significant, which is worthy of further study and application.