Pectoral Fascia Preservation Versus Resection in Modified Radical Mastectomy.

Document Type : Original Article

Authors

Surgery Department, Faculty of Medicine, Menoufia University, Egypt

Abstract

Introduction: The modified radical mastectomy (MRM) is a common surgical option for carefully selected patients
with breast cancer, but the necessity of pectoral fascia (PF) resection during the procedure has been debated.
Aim of work: To evaluate the impact of pectoral fascia preservation versus resection on surgical outcomes,
complications, and recurrence rates in patients undergoing modified radical mastectomy.
Patients and methods: We have conducted a retrospective review of patients who underwent MRM at the
Department of General Surgery, Menoufia University Hospital between January 2014 and December 2019. Patients
were divided into two groups: Group A (PF preservation, n=61) and Group B (PF excision, n=72). After propensity
score matching, there were 44 patients in each group with homogeneous patients and tumor characteristics.
Results: After matching, patients of both groups had similar demographics. Intraoperative blood loss was
significantly higher in the PF excision group (220.4±26.2 mL vs. 255±29.8 mL; P<0.001) and similarly total seroma
volume (495.3±209.3 mL vs. 805.1±385.7 mL; P<0.001), which was in favor of PF preservation. However, there
were no significant differences in recurrence rates or postoperative complications such as seroma formation, skin
necrosis, or surgical site infection.
Conclusions: Pectoral fascia preservation during MRM resulted in reduced intraoperative blood loss and seroma
formation without compromising oncological outcomes. These findings suggest that PF preservation may be a
viable option in MRM, offering a less invasive alternative with potentially improved postoperative recovery.

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