Sixty female patients diagnosed as operable breast cancer were subjected
to either radical mastectomy (first group) or to modified radical mastectomy
of Patey's (second group) in a randomized study. Each group included 30
patients. Their mean ages were 42 4 5 years and 44 4 3 years in both groups
respectively. Postoperative adjuvant radiotherapy and systemic therapy
(hormonal and chemotherapy) were given when indicated. All patients were
followed up from 24 to 36 months. Axillary clearance showed that the
number of dissected nodes were 10-22 (mean 1543) and 12-22 (mean 1444)
in both groups respectively. No operative mortality occurred in either
group. Early post-operative complications were 30% after radical
mastectomy and 10% after modified radical mastectomy; seroma in (10%)
and (3.3%), wound infection in 13.3% and 6.6% in both groups
respectively. Skin flap necrosis was observed in 6.6% in the first group and
not occurred to any of the second groups. Late post-operative complication
were 23.3% in the first group and (6.6%) in the second group; lymphoedema
in 20% and (3.3%) in both groups respectively: radiation pneumonitis
occurred in 3.3% after radical mastectomy, while radiation dermatitis
occurred in 3.3% after modified radical mastectomy. Locoregional
recurrences occurred in 6.6% in either group, while distant metastases
occurred in 16.6% after radical mastectomy and in (20%) after modified
radical mastectomy. The overall survival was 90% in the first group and
86.7% in the second group; while the disease free survival was 76.7% and
73.4% in both groups respectively during the period of follow up. In
conclusion, modified radical mastectomy of Patey is as effective as radical
mastectomy regarding the locoregional control of the'disiease, disease free
survival and the overall survival. It has less morbidity,' better cosmetic,
functional and psychological results. Therefore, we recommend the use of
modified radical mastectomy of Patey for treating patients with operable
breast carcinoma. |
