Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2015

Open Access 01-12-2015 | Research article

Partial mastectomy using manual blunt dissection (MBD) in early breast cancer

Authors: Shinichiro Kashiwagi, Naoyoshi Onoda, Yuka Asano, Kento Kurata, Tamami Morisaki, Satoru Noda, Hidemi Kawajiri, Tsutomu Takashima, Kosei Hirakawa

Published in: BMC Surgery | Issue 1/2015

Login to get access

Abstract

Background

Breast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer.

Methods

A surgical technique using manual blunt dissection (MBD), in which use of electrocautery, an ultrasonically activated scalpel, and ligation is minimized, is described. This involves an approach from small incisions in the axilla or areola to avoid injury to skin flaps, and with adequate mobilization of the breast, so that regardless of the tumor site, surgical wounds are not noticeable. The usefulness and tolerability of this surgical technique were examined.

Results

This surgical technique was evaluated in 233 patients. Surgery could be performed rapidly, with a mean operative time of 67 ± 21 min and a low mean blood loss of only 35 ± 28 ml. There was little need for postoperative analgesia, and surgery was well tolerated without postoperative bleeding or wound infection.

Conclusion

Our proposed technique for partial mastectomy using MBD provides good curative and cosmetic results.
Literature
1.
Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans E, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366(9503):2087–106.
2.
Saji S, Hiraoka M, Tokuda Y, Fukui N, Ikeda T. Trends in local therapy application for early breast cancer patients in the Japanese Breast Cancer Society Breast Cancer Registry during 2004–2009. Breast Cancer. 2012;19(1):1–3.CrossRefPubMed
3.
Jakub JW, Pendas S, Reintgen DS. Current status of sentinel lymph node mapping and biopsy: facts and controversies. Oncologist. 2003;8(1):59–68.CrossRefPubMed
4.
Fisher B, Anderson S, Bryant J, Margolese RG, Deutsch M, Fisher ER, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002; 347(16):1233–41.CrossRefPubMed
5.
Veronesi U, Cascinelli N, Mariani L, Greco M, Saccozzi R, Luini A, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. NEngl J Med. 2002; 347(16):1227–32.CrossRef
6.
Poggi MM, Danforth DN, Sciuto LC, Smith SL, Steinberg SM, Liewehr DJ, et al. Eighteen-year results inthe treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial. Cancer 2003; 98(4):697–702.CrossRefPubMed
7.
Harris JR, Levene MB, Svensson G, Hellman S. Analysi of cosmetic results following primary radiation therapy for stage I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys. 1983;52:442–5.
8.
Houvenaeghel G, Nos C, Mignotte H, Classe JM, Giard S, Rouanet P, Lorca FP, Jacquemier J, Bardou VJ. Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer: Micrometastases in sentinel lymph node in a multicentric study: predictive factors of nonsentinel lymph node involvement--Groupe des Chirurgiens de la Federation des Centres de Lutte Contre le Cancer. J Clin Oncol. 2006;24:1814-22.
9.
Cox CE, Pendas S, Cox JM, Joseph E, Shons AR, Yeatman T, et al. Guidelines for sentinel node biopsyand lymphatic mapping of patients with breast cancer. Ann Surg. 1998;227(5):645-653.
10.
Noguchi M, Motomura K, Imoto S, Miyauchi M, Sato K, Iwata H, et al. A multicenter validation study of sentinel lymph node biopsy by the Japanese Breast Cancer Society. Breast Cancer Res Treat. 2000;63(1):31–40.CrossRefPubMed
11.
Albertini JJ, Lyman GH, Cox C, Yeatman T, Balducci L, Ku N, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer. JAMA. 1996; 276(22):1818–22.CrossRefPubMed
12.
McMasters KM, Tuttle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol. 2000; 18(13):2560–2566.CrossRefPubMed
13.
Cody HS, 3rd, Fey J, Akhurst T, Fazzari M, Mazumdar M, Yeung H, et al. Complementarity of blue dye and isotope in sentinel node localization for breast cancer: univariate and multivariate analysis of 966 procedures. Ann Surg Oncol. 2001; 8(1):13–19.CrossRefPubMed
14.
Krag D, Weaver D, Ashikaga T, Moffat F, Klimberg VS, Shriver C, et al: The sentinel node in breast cancer--a multicenter validation study. N Engl J Med. 1998; 339(14):941-46.
15.
Veronesi U, Paganelli G, Viale G, Luini A, Zurrida S, Galimberti V, et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer. N Engl J Med. 2003; 349(6):546–53.CrossRefPubMed
16.
Veronesi U, Paganelli G, Galimberti V, Viale G, Zurrida S, Bedoni M, et al. Sentinel-node biopsy to avoidaxillary dissection in breast cancer with clinically negative lymph-nodes. Lancet. 1997; 349(9069):1864-67.
17.
Giuliano AE, Jones RC, Brennan M, Statman R. Sentinel lymphadenectomy in breast cancer. J Clin Oncol. 1997;15(6):2345–50.CrossRefPubMed
18.
Turner RR, Chu KU, Qi K, Botnick LE, Hansen NM, Glass EC, et al. Pathologic features associated with nonsentinel lymph node metastases in patients with metastatic breast carcinoma in a sentinel lymph node. Cancer. 2000; 89(3):574–81.CrossRefPubMed
19.
Cserni G, Gregori D, Merletti F, Sapino A, Mano MP, Ponti A, et al. Meta-analysis of non-sentinel node metastases associated with micrometastatic sentinel nodes in breast cancer. Br J Surg. 2004; 91(10):1245–52.CrossRefPubMed
20.
Lyman GH, Giuliano AE, Somerfield MR, Benson AB, 3rd, Bodurka DC, Burstein HJ, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in early-stage breast cancer. J Clin Oncol. 2005; 23(30):7703–20.CrossRefPubMed
21.
Ohuchi N, Harada Y, Ishida T, Kiyohara H, Satomi S. Breast-coserving surgery for primary breast cancer: immediate volume replacement using lateral tissue flap. Breast Cancer. 1997;4(3):135–41.CrossRefPubMed
22.
Takeda M, Ishida T, Ohnuki K, Suzuki A, Kiyohara H, Moriya T, et al. Breast conserving surgery with primary volume replacement using a lateral tissue flap. Breast Cancer. 2005; 12(1):16-20.
23.
Kashiwagi S, Onoda N, Takashima T, Asano Y, Aomatsu N, Nakamura N, et al. Breast Conserving Surgery and Sentinel Lymph Node Biopsy under Local Anesthesia for Breast Cancer. J Cancer Ther. 2012; 3:810–813.CrossRef
Metadata
Title
Partial mastectomy using manual blunt dissection (MBD) in early breast cancer
Authors
Shinichiro Kashiwagi
Naoyoshi Onoda
Yuka Asano
Kento Kurata
Tamami Morisaki
Satoru Noda
Hidemi Kawajiri
Tsutomu Takashima
Kosei Hirakawa
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2015
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-015-0102-5

Other articles of this Issue 1/2015

BMC Surgery 1/2015 Go to the issue

Research article

“Clinical significance of multifocal and multicentric breast cancers and choice of surgical treatment: a retrospective study on a series of 1158 cases”

Research article

Frequency and severity of globus pharyngeus symptoms in patients undergoing thyroidectomy: a pre-post short term cross-sectional study

Research article

Total thyroidectomy as a method of choice in the treatment of Graves’ disease - analysis of 1432 patients

Research article

Long-term outcome after bilateral lung transplantation – a retrospective study from a low-volume center experience

Research article

Laparoscopic transperitoneal lateral adrenalectomy for malignant and potentially malignant adrenal tumours

Research article

Sciatic nerve course in adult patients with unilateral developmental dysplasia of the hip: implications for hip surgery