Presrvaton Of Pectoralis Minor Muscle In Axillary Node Clearance Of Breast Cancer:

Nasser Abdel-raouf Ali Zaher

Summary and Conclusion. Summan aid COleluslolIn this study 60 patients with operable breast cancer subjected tomodified radical mastectomy they were divided into two equal groups A &B, in group A the pectroalis minor muscle was spread, while in group B thepectoralis minor muscle was removed.Twenty five percent of patients had negative nodes and 75% hadpositive nodes. When the node-positive patients were subdivided in termsof extent of involvement (1-3, 4-9 and 10 or more) there were similarproportions in both groups. The mean total number of nodes removed in thetwo groups was similar: 16.5 (range, 7-3) muscle spared group versus 17.5(range 7-34) muscle removed group. Furthermore, on analyzing the numberof dissected lymph nodes in relation to the anatomical level, no differencewas observed in numbers, at level I, II, and III in both groups.The early postoperative complications failed to demonstrate anysignificant difference between the two groups of patient apart from a slightincrease in sermoa formation, lymphodema frequency and shoulderdysfunction in patients in whom the pectoralis minor muscle was removed.The patients with pectoralis minor muscle intact had lymphedema(2/30) compared with those in which the muscle had been removed (3/30).We did not find significant difference in pain, winged scapula, orintercostobrachial syndrome after 6 months follow-up. In contrast a highlysignificant statistical difference was found between the two groups withSummary and C’,Jnclusi()nregard to the partial atrophy of the pectoralis major muscle (2/30) for thespared muscle group versus (I 8/30) for the removed muscle group.It its concluded that the mean number of dissected nodes in bothprocedures was similar. Retention of the pectoralis minor is not associatedwith under-staging or undertreatment of the axilla and also appears toprevent the partial atrophy and fibrosis of the pectorlais major. Patientstreated with preservation of the pectoralis minor muscle showed atrophy ofthe pectoralis major muscle in (6.6%) of cases versus (60%) observed inthe muscle removed group., •• ’tAL _