RCT for this will not be feasible. Tumor free margins is good enough. No need to remove pectoralis fascia in mastectomy or even BCT for small tumors. 

Dear Sidiropoulou

I agree with this role that free margin " at least 1 mm free margin" is enough.

but routinely i resect fascia of pectoral muscles especially in BCS, because if the deep margin is involved by tumor , no need to excision.

Best 

Mahmoodzadeh Habibollah

I agree with Habibollah. What use in saving pectoralis fascia? Whats the fuss about?

Preserving fascia, especialy in mastectomy, reduces sétima formation, yet, data are not clear about safety and surgeons still feel uncomfortable on preserving fascia, even if negative posterior margin is achieved

I agree with you, though, there are cases where in theory, you could preserve fascia even in mastectomy, (ex. Patient's preference with indication for rt). The problem is no such studies available.

Really when the tumor is deep and near the fascia it seems resection of fascia is better and if the deep margin will involve in pathologic report there is no need to do reexcision

Hello, I think if the tumor  is not deep and near to fascia no need to resect fascia in lumpectomy  and clear margins is enough.