41 Pectoral fascia preservation in oncological mastectomy This ‘close relationship to the PF’ was not further specified. Median follow up was 11 years (10-14 years). This study was a cross trial in which randomization for PF preservation versus PF removal also was randomized between short (1 day) or long (multiple days) axillary drainage. For the oncological outcomes, presented in both publications, the most recent publication was used.15 The first publication was used for data on complications, because those were not reported in the most recent article.14 The other RCT was reported by Abdelhamid et al, in which a total of 73 women with Grade 1 or 2 breast cancer were randomized into mastectomy with PF preservation or PF removal. The total follow up was median 41 months (34-48 months). No data were provided for regional recurrences, distant metastasis, nor mortality rates.10 Two of the included articles were retrospective case series.13, 16 Sandelin et al described a total of 203 patients who received a mastectomy with PF preservation for ductal carcinoma (n=113, 56%), lobular carcinoma (n=21, 10%) or invasive (ductal or lobular) in combination with DCIS (n=69, 34%). No patients with inflammatory carcinoma were included. All underwent a standard or skin-sparing mastectomy Positive lymph nodes N (%) Inflammatory carcinoma included Carcinoma invading or close to PF included Minimal tumor to fascia distance (mm) Follow up (years) Median (range) Comments 116 (51.1%) No No - >5 (-) Cross trial 2x2 in which also was randomized for drain duration. 115 (51.3%) No No - 11 (10-14) Long-term outcomes of same group as RCT Dalberg 2004 41 (56.2%) No No 5 - (2.8-4.0) Mean 3.4 61 (30.0%) No No - > 5 (-) 140 (60%)* No - - 2.4 (0.3-5) 3
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