A comparative study of subcutaneous mastectomy with radical mastectomy

The purpose of this study was to compare the results of 133 cases (131 pati ents) of subcutaneous mastectomy with axillary dissection between 1983 and 1999 and 910 cases of radical mastectomy during the same period. The median followup period of the subcutaneous mastectomy group and the radical maste ctomy group were 66 months and 81 months, respectively. The age at operatio n was significantly (p < 0.01) younger in the subcutaneous mastectomy group than in the radical mastectomy group and the clinical stage was significan tly (p < 0.01) earlier. Lymph node metastasis was significantly (p < 0.01) higher in the radical mastectomy than in the subcutaneous mastectomy group. There was no difference in ER status between the two groups. There was loc al recurrence in 5 (3.8%) members of the subcutaneous mastectomy group and in 12 (1.3%) members of the radical mastectomy group, There was no differen ce in disease-free survival and overall survival between the two groups. Di vided into two subgroups by lymph node status, there was no difference in d isease-free survival and overall survival between the two groups. Local rec urrence occurred more frequently (p < 0.05) in the subcutaneous mastectomy group, however, than in the radical mastectomy group when no lymph node met astasis was found. Multivariate analysis using the Cox hazard model showed that operation method and lymph node status were independent prognostic fac tors for local recurrence, whereas, lymph node status and ER status were in dependent prognostic factors of disease-free survival. In conclusion, subcu taneous mastectomy presents a risk factor for local recurrence, but the sur vival rate of the subcutaneous mastectomy group is as favourable as the rad ical mastectomy group.