Evaluation of Auchincloss’ Modified Radical Mastectomy in the Management of Advanced Breast Cancer

Abstract:

Background: Mastectomy for breast cancer has progressed from radical approaches in the past to the breast conservative therapies (BCT) of today. Less invasive procedures followed by axillary dissection or radiotherapy achieves better cosmetic and similar prognostic outcome than radical approaches. Auchincloss modified radical mastectomy was originally described for level 1 and 2 axillary node dissection but has since been extended to include level 3 node clearance with variable results. Majority of our patients present late with level 2 and 3 axillary node involvement thereby making BCT impracticable. Aim: To evaluate effectiveness of Auchincloss’ modified radical mastectomy in loco-regional control of stages II and III breast cancer. Method: We recruited consecutive patients presenting to the surgical clinic of our hospital with breast cancer between 2017 and 2018 and administered questionnaires for demographics and clinical stage. They were subsequently counseled and offered mastectomy. Results A total of 51 patients were seen. All were females. Age range was between 30 and 70 years. Mean age was 46.8 years; median age 47 years while modal age was 47 years. One patient (1.96%) presented with stage IIB disease, 27 patients (52.94%) with stage IIIA, 8 patients (15.69%) with stage IIIB and 15 patients (29.41%) with stage IIIC disease. Three patients (5.88%) developed postoperative wound infection, 2 patients (3.85%) arm edema, 1 patient (1.96%) axillary node recurrence, 1 patient (1.96%) local chest wall recurrence and 2 patients (3.85%) developed seroma. Forty-two patients (82.35%) had no reportable post-operative complication. Conclusion: Auchincloss’ modified radical mastectomy is effective in loco-regional control of advanced breast cancer.