40 Chapter 3 RESULTS Study and patient characteristics A total of 1961 articles were identified. Nine possibly relevant articles were identified by cross-reference check. After removal of duplicates 1300 articles remained, and 38 were found to be possibly relevant after screening titles and abstracts. These 38 manuscripts were assessed for eligibility, of which five articles were included. (Figure 1; Table 1) Three articles reported outcomes of two Randomized Controlled Trials (RCT’s).10, 14, 15 Two of those concerned the RCT reported by Dalberg et al, with different lengths of follow up.14, 15 In this study n=244 female patients were randomized to either mastectomy with PF preservation (n=123) or PF removal (n=121). Patients were with invasive breast cancer (n=227 / 91.9%) or DCIS (n=20 / 8.9%) aged 75 or younger and requiring a mastectomy were included. Exclusion criteria were inflammatory breast cancer or a tumor located close to the PF clinically or on mammogram. Table 1. Study and patient characteristics of the five included studies. Study Reference Study Type Country No. patients Age Mean (SD) No. mastectomies Invasive carcinoma N (%) Dalberg, 2004 RCT Sweden 247 58.1 (-) 247 227 (91.9%) Dalberg, 2010 RCT Sweden 244 58.2 (-) 244 224 (91.8%) Abdelhamid, 2017 RCT Egypt 73 56.7 (-) 73 73 (100%) Sandelin, 2004 Retrospective Sweden 203 - (-) Median (range) 48 (23-70) 203 203 (100%) Salgarello, 2011 Retrospective Italy 220 47.5 (-) (range) (25-72) 256 234 (91.4%) PF: pectoral fascia. SD: Standard deviation. * 40% had no indication for total axillary lymph node dissection after sentinel node procedure. Therefore the 140 (60%) that underwent total axillary lymph node dissection are expected to be the number of patients with positive lymph nodes.
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