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

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

Breast-preserving surgery (Bp) and sentinel lymph node biopsy (SNB) are established as standard treatment for axillary lymph node-negative early breast cancer. 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. 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. Our proposed technique for partial mastectomy using MBD provides good curative and cosmetic results.