A new study from the RCSI Beaumont Cancer Centre has found that a long-established method of mastectomy surgery for breast cancer is as safe and effective as newer technologies and achieved equally good outcomes for patients.

The research compared surgeries using two types of electrosurgical devices that are commonly used during mastectomy for both cutting (dissection) and minimisation of blood loss (haemostasis).

The study, published in the British Journal of Surgery, is the first randomised clinical trial to assess whether using a newer vessel-sealing device achieved better surgical outcomes than the more established alternative for simple mastectomy surgery. A simple mastectomy is a surgery that removes the breast tissue, nipple, areola and skin but not all the lymph nodes.

Breast cancer is the most common cancer in women worldwide and surgery remains a crucial component of treatment for many patients. The clinical trial was carried out in partnership with 86 patients who attended the RCSI Beaumont Cancer Centre over a four-year period.

Of these patients 42 were randomised to the monopolar device group and 44 to the vessel-sealing device group. The study measured outcomes including the number of days when patients required a drain, which signifies the volume of fluid collecting in the surgical cavity; and total duration of the operative time. There was no significant difference in outcomes between the two groups in terms of drain duration in situ or the amount of time the surgery took. 

Best outcomes

The study’s senior author, Professor Arnold Hill, Professor of Surgery at RCSI University of Medicine and Health Sciences, commented on the trial saying: “At the Beaumont RCSI Cancer Centre, our goal is to provide comprehensive patient-centric cancer care, informed by cutting-edge research and this clinical trial to assess methods of mastectomy surgery is an important piece of work to ensure we are delivering the best outcomes for patients. 

“Our findings demonstrate that that the long-established monopolar diathermy is as effective and safe to use as the newer vessel sealing device. By utilising the long-established device, we can perform surgeries cost-effectively ensuring that our health services resources are used efficiently for the benefit of patients, while maintaining world-class standards of excellence in cancer care.

“Although this trial looked at mastectomy surgery specifically, the findings are relevant for other general surgeries.”

Dr Stephen Keelan was first author on the study, 'Randomised Controlled Trial of Monopolar Diathermy Versus Vessel Sealing', which was carried out in collaboration with colleagues in RCSI’s Department of Surgery and the Health Outcomes Research Centre at RCSI School of Population Health.