Mohamed, H., Mansy, O., Elkammash, S., Hokkam, E., Ramadan, A. (2022). Oncological Safety of Pectoralis Fascia Preservation in Modified Radical Mastectomy. Suez Canal University Medical Journal, 25(4), 61-69. doi: 10.21608/scumj.2022.272617
Haidi A. Mohamed; Omar M. Mansy; Soliman H. Elkammash; Emad N. Hokkam; Ahmed A. Ramadan. "Oncological Safety of Pectoralis Fascia Preservation in Modified Radical Mastectomy". Suez Canal University Medical Journal, 25, 4, 2022, 61-69. doi: 10.21608/scumj.2022.272617
Mohamed, H., Mansy, O., Elkammash, S., Hokkam, E., Ramadan, A. (2022). 'Oncological Safety of Pectoralis Fascia Preservation in Modified Radical Mastectomy', Suez Canal University Medical Journal, 25(4), pp. 61-69. doi: 10.21608/scumj.2022.272617
Mohamed, H., Mansy, O., Elkammash, S., Hokkam, E., Ramadan, A. Oncological Safety of Pectoralis Fascia Preservation in Modified Radical Mastectomy. Suez Canal University Medical Journal, 2022; 25(4): 61-69. doi: 10.21608/scumj.2022.272617
Oncological Safety of Pectoralis Fascia Preservation in Modified Radical Mastectomy
Department of Surgery, Surgical Oncology Unit, Faculty of Medicine, Suez Canal University hospital, Egypt.
Abstract
Background: In oncological mastectomy procedures, the pectoral fascia (PF) is frequently excised. The risk of bleeding, infections, and seroma following surgery may be lower if the PF is preserved. Better prosthesis coverage may also enhance reconstructive results, decreasing implant extrusion rates and enhancing cosmetic results. Aim: To assess the oncological safety and the early complications of pectoralis fascia preservation in modified radical mastectomy. Patients and Methods: This randomized control experiment was carried out in Suez Canal University Hospitals' operating rooms and surgical inpatient wards. There were two groups of patients: Between June 2020 and March 2022, patients in (Group A) received preservation of the pectoral fascia, and (Group B) underwent excision of the pectoral fascia. Results: Patients who had pectoralis fascia preservation had significantly lower cumulative seroma volume than those who had pectoralis fascia excision (p < 0.001). Conclusion: It is not required to routinely remove the pectoralis fascia. Regardless of tumor staging, PF can be safely preserved when the tumor is more than five millimeters’ distant from the deep aspect of the breast. However, care should be taken when handling situations where the breast's excessive distortion makes determining this distance challenge. Research should be done to find more effective techniques than the surgeon's perception of the invasion. Whenever possible, the fascia beneath the tumor should be partially resected.
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