Breast Surgery

Question 1

Which fascial layer will be divided during the surgical approach to axilla?

Answer 1

Clavipectoral fascia.

The clavipectoral fascia is situated under the clavicular portion of pectoralis major. It protects both the axillary vessels and nodes. During an axillary node clearance for breast cancer the clavipectoral fascia is incised and this allows access to the nodal stations. The nodal stations are; level 1 nodes inferior to pectoralis minor, level 2 lie behind it and level 3 above it. During a Patey Mastectomy surgeons divide pectoralis minor to gain access to level 3 nodes. The use of sentinel node biopsy (and stronger assistants!) have made this procedure far less common.

Question 2

What is the most appropriate device to use for MAC?

Answer 2

Closed suction drainage system made of polypropylene