TY - CHAP M1 - Book, Section TI - Mastectomy and Breast Reconstruction A1 - Hunt, Kelly K. A1 - Kronowitz, Steven J. A2 - Morita, Shane Y. A2 - Balch, Charles M. A2 - Klimberg, V. Suzanne A2 - Pawlik, Timothy M. A2 - Posner, Mitchell C. A2 - Tanabe, Kenneth K. Y1 - 2018 N1 - T2 - Textbook of Complex General Surgical Oncology AB - Mastectomy has been utilized in the surgical management of patients with breast cancer for centuries. It was William Stewart Halsted who popularized the technique of radical mastectomy after his initial publication in the mid-1890s.1 Halsted believed that breast cancer spread from the primary tumor in the breast parenchyma to the regional lymph node basins and then to distant sites. He felt that this sequential progression of spread could be halted if all of the breast tissue, skin, chest wall musculature, and regional lymphatics were resected. In addition to the extensive chest wall resection, the Halsted radical mastectomy included removal of the level I, II, and III axillary lymph nodes. Halsted’s initial publication reported a 5-year survival rate of 40% and a local-regional control rate of 73%. The extended radical mastectomy was introduced to include internal mammary nodal dissection based on retrospective comparisons showing improved survival with the more extensive procedure. A multinational randomized trial was initiated in the 1960s to compare survival rates with the Halsted radical mastectomy versus the extended radical mastectomy.2 The trial did not show any difference in survival outcomes between the two surgical procedures, however it was underpowered and patients were not staged and selected for participation based on imaging studies. Subsequent studies failed to confirm any survival advantage with the extended radical mastectomy and this procedure was largely abandoned in favor of radiation to the regional nodes. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/13 UR - accesssurgery.mhmedical.com/content.aspx?aid=1145760490 ER -