PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Mastectomy, Modified Radical”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Modified radical mastectomy in local anesthesia].

The authors report their experience on the use of local anesthesia for modified radical mastectomy. They have used this modality in five patients who could not undergo general anesthesia because of underlying severe medical illness and in a sixth one who adamantly refused general anesthesia. They describe in detail the technique used, stressing the importance of a thorough knowledge of regional neuroanatomy. There were no complications in their small series. The authors conclude by stating that the use of local anesthesia may expand the indications for "toilet mastectomy" to include patients in poor medical condition, unsuitable for general anesthesia.

Aged↗
PubMed1978

Modified radical mastectomy.

The recent history of operations for breast cancer indicates a growing trend toward conservatism. The modified radical mastectomy achieves the goal of removing all evidence of cancer in the breast involved and removes the regional lymph nodes for accurate staging of the disease. In addition, it provides a cosmetic result superior to that of the standard radical mastectomy. Breast reconstruction may be undertaken at a later time with excellent result. The 5 and 10 year survival rates of comparable groups of patients after modified radical mastectomy and standard radical mastectomy appear to be almost identical.

Biopsy↗
PubMed1984

Lateral pectoralis nerve: the need to preserve it in the modified radical mastectomy.

The preservation of the medial pectoralis nerve is classical and compulsory in the Patey Modified Radical Mastectomy, which innervates the clavicular and sternal insertions of the pectoralis major muscle. The lateral pectoralis nerve innervates the lower third, and the costo-abdominal insertions of the pectoralis major muscle. The tight relationship of this nerve with the pectoralis minor muscle makes it impossible to resect the muscle without damaging the nerve. The lesion of this nerve causes fibrosis, atrophy and shortening of the pectoralis major muscle, limitations of the shoulder movements, and a certain degree of skeletonization of the chest wall. Routine removal of the pectoralis minor muscle, as seen in Patey's type operation, with sectioning of the lateral pectoralis nerve, and the above mentioned sequela, is not recommended since it destroys the cosmetic result which is the main objective of the surgery. In naming these structures we prefer Moosman's proposal, because it is easier to remember, it adapts better to our surgical training, and it denotes course location and distribution. We encourage the preservation of the pectoralis minor muscle, and the lateral pectoralis nerve in the modified radical mastectomy, following the Scanlon's proposal in the hope of maintaining a cosmetic aspect and an appropriate base for the reconstructive surgery.

Esthetics↗
PubMed2002

Breast-conserving therapy versus modified radical mastectomy in the treatment of early breast cancer in Japan.

BACKGROUND: Breast-conserving therapy has been widely utilized as a treatment option for women with early breast cancer. However, no randomized study comparing modified radical mastectomy and breast-conserving therapy has been conducted in Japan. METHODS: Two hundred and twenty-eight Japanese women with early breast cancer enrolled in the Gunma Breast Conserving Therapy Study between 1991 and 1994 were examined to determine whether there is any difference in disease-free survival or overall survival between radical mastectomy and breast-conserving therapy. After informed consent was obtained, a total of 119 patients underwent breast-conserving therapy and 109 underwent mastectomy. RESULTS: Mastectomy was a more frequently utilized treatment than breast-conserving therapy in patients with clinical stage II lesions, older age, larger tumor size or shorter distance between tumor and nipple. The mean follow-up period for all patients was 81 months (median 86 months). There was no significant difference in overall survival or disease-free survival between breast-conserving therapy and mastectomy even after adjusting for the clinical stage of the disease. A multivariate analysis of tumor size, lymph node status, estrogen receptor status and operation method using the Cox proportion hazard model confirmed that only lymph node status was an independent prognostic factor. CONCLUSION: Breast-conserving therapy is comparable to modified radical mastectomy in overall survival and disease-free survival.

Adult↗
PubMed1992

Axillary versus combined axillary and pectoral drainage after modified radical mastectomy.

Initial attempts to obliterate dead space and minimize fluid accumulation in patients after mastectomy using closed suction drainage, used insertion of a single axillary drain. Today, surgeons often insert two drains in the postoperative wound, one in the axilla and the other beneath the pectoral flaps. The current study was done to determine whether or not there is an advantage in using two drains rather than a single axillary drain after mastectomy. A randomized, clinical trial was conducted with 84 women undergoing modified radical mastectomy. Thirty-seven patients had one axillary drain and 47 had two drains placed postoperatively, one in the axilla and the other beneath the pectoral flaps. Follow-up results were obtained four weeks postoperatively for complication data, including seroma and hematoma formation, flap necrosis and infection. The average total drainage was 870.4 milliliters per patient in the group with one drain and 997.4 milliliters per patient in the group with two drains (p value not significant). The overall complication rate in the group with one drain was 35.0 percent compared with a rate of 31.9 percent for all complications observed in the group with two drains. These differences did not reach statistical significance. Comparing the frequency of each complication in the two groups again showed no significant difference. However, the data suggest a trend toward an increased incidence of flap necrosis in the group with two drains that used a drain beneath the pectoral flaps. Use of a single axillary drain after modified radical mastectomy seems to result in no increase in postoperative complications, is less costly and may assist in reducing the incidence of flap necrosis.

Adult↗
PubMedDate not supplied

Modified radical mastectomies: average charges, 1988.

Average charge of $6,160 was billed to Metropolitan Life Insurance Company for 807 modified radical mastectomies during 1988. The average physicians' fees were $2,090. Length of hospital stay averaged 4.3 days across the country. The charges varied by as much as 92 percent between states. Among the 19 states included in the study, New York and California reported the highest average total charges ($7,870 and $7,290) and Iowa and Minnesota reported the lowest average charges ($4,100 and $4,620). On average, hospital expense comprised 66 percent of the total charges and ancillary fees accounted for almost three-fourths of the hospital bill.

Adult↗
PubMed1988

[Breast reconstruction using a skin expander prostheses following modified radical mastectomy].

In the period from September 1983 to May 1986, 116 breast reconstructions were performed at Heidelberg University Gynecological Clinic with the aid of skin expander prostheses, following modified radical mastectomy (89 primary and 27 secondary reconstructions). In 18% of all cases, complications occurred due to the expanders, the most common being loss of prosthesis material. A total of 82 women have meanwhile had the expander prosthesis replaced by a definitive gel prosthesis in a "second reconstruction phase". Reconstruction of the nipple and areola has been performed in six cases in a third phase. Today, breast reconstruction in one or two stages following modified radical mastectomy represents an integral part of surgical rehabilitation of primarily operable breast cancer in cases, where a primary conservative procedure is out of the question.

Adult↗
PubMed1993

The modified radical mastectomy of Patey: technique and experience.

We report our experience from 193 patients with breast cancer treated by Modified Radical Mastectomy of Patey and describe the technique used, amplified by illustrations. We achieved a low morbidity viz symptomatic lymphoedema five cases, chronic shoulder stiffness one case, skin grafting two cases, and all cases of chest wall pain cleared by four years. Cancer recurred, to date, local in nine cases (4.6%), local and systemic in 17 cases (8.9%) and systemic in 27 cases (13.9%). We compile, for the first time, all references by Patey and Richard Handley to the procedure. We recommend the operation as achieving complete primary clearance with safe and full axillary node removal. Histological state of the nodes allows rational decisions on adjuvant therapy with hormones and chemotherapy.

Breast Neoplasms↗
PubMed2003

Comparison of remifentanil and fentanyl in patients undergoing modified radical mastectomy or total hysterectomy.

OBJECTIVE: To compare the efficacy and safety of remifentanil and fentanyl in patients undergoing a modified radical mastectomy or total hysterectomy. METHODS: Fifty-four patients were evenly randomised into remifentanil group and fentanyl group. Anesthesia was induced by propofol (1 - 2 mg/kg) and either remifentanil (2 microg/kg) or fentanyl (2.5 microg/kg), and was maintained with inhalation of nitrous oxide in oxygen (2:1) and continuous infusion of either remifentanil (0.2 microg.kg(-1).min(-1)) or fentanyl (0.03 microg.kg(-1).min(-1)). RESULTS: The number of patients exhibiting light anesthesia responses in the remifentanil group during intubation and the maintenance of anesthesia was significantly less than that in the fentanyl group. Both systolic and diastolic blood pressures in the fentanyl group were significantly higher than those in the remifentanil group during intubation, skin incision, maintenance of anesthesia and extubation. The time to opening eyes on command and the time for extubation after surgery was comparable between the two groups. More patients in the remifentanil group (25 patients) required bolus injection of morphine for postoperative pain relief than those in the fentanyl group (5 patients, P < 0.05). There was no significant difference between the two groups in terms of side effects. CONCLUSIONS: Under the condition of this study protocol, the anesthetic and analgesic effects of remifentanil are more potent than those of fentanyl. Remifentanil can offer superior intraoperative hemodynamic stability in comparison with fentanyl, and has no compromising recovery from anesthesia.

Adolescent↗
PubMed1982

Brachial plexus block for pain relief after modified radical mastectomy.

Brachial plexus block using an intraclavicular approach was performed at the completion of surgery in 47 patients having modified radical mastectomies. In 48 control patients having similar operations, brachial plexus block was not performed. Of the 47 patients in whom brachial plexus block was performed, 26 (55%) required analgesia during the first 24 hours after the operation, whereas 44 (91%) of the 48 control patients required analgesics (p less than 0.0005). The time elapsed between the end of anesthesia and requirement of the first analgesic was significantly longer when the brachial plexus was blocked (p less than 0.001). The efficacy, simplicity, and safety of blocking the brachial plexus at the completion of surgery following modified mastectomy demonstrate that this technique could be routinely used for the relief of postoperative pain in patients having modified radical mastectomies.

Analgesics↗
PubMed1999

Timing of shoulder exercise after modified radical mastectomy: a prospective study.

BACKGROUND: There are several factors those contribute to the amount of axillary drainage after modified radical mastectomy. The drains should be removed as early as possible. Whether the active shoulder movement of the lesion side increases the amount of axillary drainage needs to be studied prospectively. METHODS: From 1994 through 1995, 344 consecutive patients were randomly divided into three groups. One hundred sixteen patients in the early group performed upper arm exercises including pendulum, wall climbing and pulley exercises beginning the third post-operative day. One hundred fifteen patients in the later group patients did the same exercises beginning the sixth post-operative day and 113 patients in the delayed group did the same exercises after all the drains were removed. RESULTS: There were no significant differences in patient characteristics, including age, body weight, operation methods and the pathology in the three groups. The amount of axilla fossa drainage was significantly less in the patients in the delayed group than in the early and later group (485 ml, 568 ml, 559 ml, respectively, p = 0.032). However, there were no differences in the amount of chest wall site drainage or the number of aspiration of seroma among the three groups. The drains were removed on the average of seventh and ninth post-operative day in the delayed and early group patients, respectively (p = 0.124). Although the range of motion (ROM) of the shoulders in the delayed group patients was slightly limited during the first month after operation, ROM returned at 3 months and no difference was found 6 months after operation. CONCLUSION: Upper arm exercise can start after the drains in the axilla are removed. The delay does not limit the shoulder function at 6 months after modified radical mastectomy.

Adult↗