A Randomized Controlled Study of Quilting with Axillary Lymphatic Ligation Versus Conventional Modified Radical Mastectomy in Patients with Breast Cancer

Postmastectomy seroma formation is a common and notorious problem that every treating surgeon frequently faces in the management of patients with breast cancer. Several technical modifications and innovations have been proposed to either overcome or reduce its occurrence. One such method tested in this study in a randomized way was axillary lymphatic vessel ligation and quilting. A total of 120 patients undergoing modified radical mastectomy for breast cancer were randomized to undergo either conventional modified radical mastectomy (MRM) or MRM with axillary lymphatic vessel ligation using a loupe magnification and quilting. Both the groups were identical in terms of baseline characteristics. Compared to conventional MRM, experimental group was associated with statistically significant longer operative time, more blood loss, less seroma aspirations, early drain removal, shorter hospital stay, early start of adjuvant chemotherapy, and better ipsilateral shoulder function. To conclude axillary lymphatic vessel ligation and quilting, the technique needs to be incorporated into the technique of MRM and the relative contribution of each of these strategies needs to be explored further through newer studies.