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PubMed2004

Evaluation of arm and shoulder mobility and strength after modified radical mastectomy and radiotherapy.

Seventy-five women, of whom 30 had received postoperative radiotherapy, were tested for range of motion (ROM) and shoulder strength with a goniometer and an isokinetic device (Orthotron II), respectively. On the individual level, irradiated patients exhibited significantly reduced range of motion (varying from p < 0.05 to p < 0.001) for all movements compared with the non-operated side. In contrast, in the non-irradiated patients only flexion was significantly reduced (p < 0.05). The same individual pattern was evident for shoulder strength where all movements except external rotation were significantly reduced in irradiated patients (varying from p < 0.05 to p < 0.001). Non-irradiated patients exhibited a significant reduction in shoulder strength for flexion and abduction (p < 0.05), whereas other movements were less affected. The observed differences in ROM and strength were less pronounced when analyzed on a group level, but were still significant for ROM (p < 0.001) for flexion and abduction. Group level analysis also showed reduced shoulder strength for all movements but only rotation was significantly (p < 0.01) impaired.

Adult↗
PubMed1993

A 25-year prospective study of modified radical mastectomy (Patey) in 193 patients.

The results of a prospective study over 20 years of 193 patients with breast carcinoma treated by Patey mastectomy are presented together with details of the operative technique employed. One hundred and twenty-eight cases (66%) were stage 1 (T1/T2 N0), 46 (24%) were stage 2 (T1/T2 N1), 18 (9%) were stage 3 (T3 N0/N1), and one was stage 4 (M1). The probability of survival together with 95% confidence intervals for stage 1 (T1/T2 N0) at 10 years was 79% (71-88); and at 15 years 74% (61-87). For stage 2 (T1/T2 N1), the probability of survival at 10 years was 64% (48-79), and at 15 years 60% (44-76). For stage 3 (T3 N0/N1), the probability of survival at 10 years was 70% (45-95) and nobody survived at 15 years. These differences between the clinical stages lacked significance [Log-rank test: chi 2 = 3.44 df = 2 P = 0.18]. There were nine patients (5%) who developed local recurrence without systemic metastases. There was no postoperative mortality, and morbidity was low. Axillary node metastases depressed survival with probability of survival at 10 years 43% (29-57) in contrast to those without it 90% (84-96) [log-rank test: chi 2 = 39.42 df = 1 P < 0.0001]. Patey mastectomy should be considered for patients with T1 or T2 tumours who choose mastectomy rather than breast conservation. It is an effective local treatment which is of particular relevance in countries where radiotherapy is not available.

Breast↗
PubMed1988

Scalpel versus electrocautery in modified radical mastectomy.

Forty nine consecutive mastectomy patients were randomized to one of two groups. Twenty four patients had skin flaps created with the cold scalpel and twenty five with the electrocautery. The two groups were similar with respect to age, stage of disease, size of tumor, and weight. Cautery patients had significantly less operative blood loss when compared with scalpel patients, 352 versus 507 milliliters, respectively, P less than 0.05. No cautery patient required transfusion compared with three transfused scalpel patients, P less than .005. Total postoperative hemovac drainage and hospital stay were not significantly different between the two groups. Although the number of fever days and wound complications were slightly higher in the cautery group, the difference was not statistically significant. The electrocautery may be superior to the scalpel for mastectomy.

Electrocoagulation↗
PubMed1979

[Treatment of cancer of the breast with Patey's modified radical mastectomy].

Patey's operation was used to treat breast cancer in 658 cases between 1956 and 1976 at the Bologna University Surgical Clinic. Follow-up in 562 cases revealed 5-yr and 10-yr survival rates substantially similar to those obtained by Halsted and others. It is felt that the type of operation used is of relative importance for survival, since breast cancer is dependent on other factors that require careful appraisal in each case.

Breast Neoplasms↗