Indication Of Modified Radical Operation (Patey) On Breast Cancer For Preserving Nipple-Areolar Complex

Breast cancer is one of the most common tumor impacting physicaland mental health seriously in women, even life-threatening. Since 19century, radical operation on breast cancer has been the importantmethod, but the major patients were failure because of local recurrentor matastasis. There is no significant difficience in survival ratebetween modified radical mastectomy and traditional radicalmastectomy.Patey is an ideal method. Its long term effect is similar totraditional radical mastectomy. With the development of breastreconstruction, it is more and more important for modified radicalmastcetomy on breast cancer with nipple-areolar complex(NAC)preservation.Objective To explore the indication of Patey on breast cancer withnipple-areolar complex(NAC) preservation.Method From February 2004 to February 2006, there were 239 casesafter breast cancer surgery. 239 breast cancer patients were dividedinto five groups according to surgery method: group A (involded 45 casesin Halsted), group B(involded 31 cases in Anchincloss), groupC(involded 115 cases in Patey), group D(involded 52 cases in Patey withnipple-areolar complex(NAC) preservation), group E(involded 19 casesin Patey with nipple-areolar complex(NAC) preservation and immediatebreast reconstruction). Complication and following-up of all methodswere analyzed.Result In the incidence rate of flap necrosis and subcutaneousfluid , group A was 11.11%(5/45), 51.11%(23/45), group B was 9.68%(3/31),54.84%(17/31), group C was 10.43%(12/115), 46.09%(53/115),group D was9.61%(5/52), 65.38%(34/52), group E was 10.53%(2/19), 94.74%(18/19).The incidence rate of NAC necrosis in group D was 2.08%. Theincidence rate of region recurrence in group A,B,C,D was7.14%,7.14%,6.25%,6.25%. There existed no NAC necrosis or region recurrence in groupE.Conclusions 1. Patey on breast cancer for preservingnipple-areolar complex shoud be useful for stage I and stage II breastcancer patients.2. We should consider the distance between tumor andnipple-areolar complex, axillary lymph node, tumor size, stage and NACclinical manifestation and the involvement of the NAC when modifiedradical mastcetomy on breast cancer with nipple-areolar complex(NAC)preservation is carried out. We are sure of the indication of modifiedradical mastcetomy on breast cancer with nipple-areolar complex(NAC)preservation. That is: (1)It was confirmed that tumor was single, D≥2.5cm, breast cancer is limited on stageⅠorⅡ. (2)NAC is not beeninvolved by tumor. (3)Ipsilateral axillary lymph node is negative oris the one whose diameter is less than 2cm.(4) The patient could acceptadjunct medicine after radical mastcetomy.3. It is good for the aesthetic outcome of Patey on breastcancer with nipple-areolar complex(NAC) preservation.4. Modified radical mastcetomy on breast cancer for preservingnipple-areolar complex is a good kind of method for immediate breastreconstruction or breast reconstruction and prosthesis implantationafter surgery.5. Elastic pressure dressing jacket can decrease the incidencerate of fluid efficiently after surgery. It can protect bloodcirculation from being necrosis of NAC.