Modification of muscle-preserving radical mastectomy.

A technical improvement of the muscle-preserving radical mastectomy for breast cancer is presented. In this procedure, the Sulcus interpectoralis, located between clavicular and sternocostal parts of the pectoralis major muscle, is split bluntly and spread apart. Then, the pectoralis minor muscle is severed near its attachment to the coracoid process and an axillary dissection is thereby easily and thoroughly accomplished. The effectiveness of lymph node dissection by this method was ascertained when the number of the lymph nodes removed by this procedure was compared with that removed by the conventional muscle preserving mastectomy (Madden's operation) and the radical mastectomy. Ninety-three patients treated by this operation have shown a satisfactory cosmetic appearance and a good prognosis when compared with patients treated by the standard radical mastectomy.