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Original ArticleOpen Access
Mastectomy without Drain at Pectoral Area : A Randomized Controlled Trial
Puttawibul P 
,
Sangthong B ,
Maipang T ,
Sampao S ,
Uttamakul P ,
Apakupakul N
,
Sangthong B ,
Maipang T ,
Sampao S ,
Uttamakul P ,
Apakupakul N Objectives : Mastectomy is still one of the standard alternative procedures for the management
of female breast cancer. Axillary node dissection is also performed to establish the accurate
staging. After operation, the axilla must be drained because of lymphatic leakage. Whether the raw
surface at the pectoral area should be drained or not is an interesting controversial point. The authors
conducted a randomized controlled trial to compare outcomes after modified radical mastectomy
(MRM) with and without drainage at the pectoral area.
Methods : Sixty patients who agreed to be treated with MRM and had given their consent
were enrolled. Mastectomy was performed to remove the breast tissue proper by scalpel in order to
minimize tissue injury. The axillary contents were removed by sharp instrument. After b!eeding had
stopped, patients were randomly allocated to one or other of 2 groups: group I (n = 30): only I drain
was inserted at the axilla area; group II (n = 30): 2 conventional drains were inserted into the pectoral
area and axilla area. The size of tube drain and negative suction pressure were constant in all cases.
Volume of contents was recorded daily. Subcutaneous seroma or hematoma were carefully observed
and confirmed by ultrasonography 3-5 days after operation. Overall drainage contents and complications
were compared.
Results : The mean weight of breast tissue of group I was 632.1 g and group II 654.0 g (p =
0.81). Total drainage contents (median) from the two groups were 250 cm3 and 231 cm3 respectively
(p = 0.796). Complications occurred in 1 case in group I and 2 cases in group II (p = 0.35). None of
the above differences were statistically significant.
Conclusion : Mastectomy by scalpel can be performed without drainage at the pectoral area.
Overall complications in the conventional group and the group without drain did not differ significantly.
Key word : Mastectomy, Sharp Dissection
of female breast cancer. Axillary node dissection is also performed to establish the accurate
staging. After operation, the axilla must be drained because of lymphatic leakage. Whether the raw
surface at the pectoral area should be drained or not is an interesting controversial point. The authors
conducted a randomized controlled trial to compare outcomes after modified radical mastectomy
(MRM) with and without drainage at the pectoral area.
Methods : Sixty patients who agreed to be treated with MRM and had given their consent
were enrolled. Mastectomy was performed to remove the breast tissue proper by scalpel in order to
minimize tissue injury. The axillary contents were removed by sharp instrument. After b!eeding had
stopped, patients were randomly allocated to one or other of 2 groups: group I (n = 30): only I drain
was inserted at the axilla area; group II (n = 30): 2 conventional drains were inserted into the pectoral
area and axilla area. The size of tube drain and negative suction pressure were constant in all cases.
Volume of contents was recorded daily. Subcutaneous seroma or hematoma were carefully observed
and confirmed by ultrasonography 3-5 days after operation. Overall drainage contents and complications
were compared.
Results : The mean weight of breast tissue of group I was 632.1 g and group II 654.0 g (p =
0.81). Total drainage contents (median) from the two groups were 250 cm3 and 231 cm3 respectively
(p = 0.796). Complications occurred in 1 case in group I and 2 cases in group II (p = 0.35). None of
the above differences were statistically significant.
Conclusion : Mastectomy by scalpel can be performed without drainage at the pectoral area.
Overall complications in the conventional group and the group without drain did not differ significantly.
Key word : Mastectomy, Sharp Dissection
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