Preservation of pectoralis minor in axillary clearance for breast cancer

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BackgroundThere has been a gradual shift away from radical surgery towards conservation treatment for breast cancer. The pectoralis minor muscle is increasingly preserved in women undergoing axillary clearance as part of either breast conservation or mastectomy.MethodsA retrospective study was conducted to determine the axillary node count in 578 patients who underwent axillary clearance, 276 with removal of pectoralis minor and 302 who had the muscle preserved.ResultsThe mean number of nodes excised in the group who had pectoralis minor excised was 25.5 (range 8-50) compared with 24.5 (range 9-68) in the preservation group.ConclusionFor the majority of patients with operable breast cancer, retention of the pectoralis minor muscle is not associated with understaging or undertreatment of the axilla.

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