TY - CHAP M1 - Book, Section TI - Chapter 68. Radical and Extended Radical Mastectomy A1 - Fearmonti, Regina M. A1 - Beahm, Elisabeth K. A2 - Kuerer, Henry M. PY - 2010 T2 - Kuerer's Breast Surgical Oncology AB - Halsted advocated radical mastectomy (RM) to achieve locoregional control for breast cancer at the end of the 19th century, stemming from his theory of the sequential progression of breast cancer metastases from the primary tumor to regional lymphatics and on to distant sites.1 The RM and extended radical mastectomy (ERM) embodied the theory of aggressive local control, and emerged as mainstays of surgical treatment for breast cancer (Fig. 68-1). Nonetheless, as early as 1912, Murphy and other proponents of pectoralis muscle preservation began to challenge these techniques with modified radical mastectomy (MRM) and total mastectomy. They demonstrated adequate local control without the associated cosmetic and functional morbidities.2 Patey and Dyson later modified the Halsted technique for resection of small (T1 and T2) breast cancers, advocating level I, II, and III axillary dissection, preserving pectoralis major, and removing only the pectoralis minor muscle.3,4 Neoadjuvant chemotherapy further served to lessen the surgical approach required by greatly facilitating resectability. The criteria for breast cancer inoperability published by Haagensen and Stout were established before the wide acceptance and advances in chemotherapy and modern radiation techniques.5 Accordingly, criteria for the role of surgery in locally advanced breast cancer (LABC) are evolving, yet still remain largely reserved for palliation, comfort, hygiene, and wound management.6 SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=6415159 ER -