J.Jpn. Surg. Soc.. 61(2): 248-263, 1960

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EVALUATION OF MASTECTOMY WHITHOUT RESECTION OF THE PECTORAL MUSCLE AS A TREATMENT FOR CANCER OF THE BREAST

(1) The results obtained from the two different methods were compared and discussed of 126 cases of cancer of the breast which were encountered in the Surgical Department of the Keio University Hospital in the past 12 years, in which of 56 cases received Halsted's radical mastectomy and of 70 mastectomy with dissection and cleaning of the axillar region without resection of the pectoral muscles.
(2) The 5-year-survival-rate to the all cases was 72.0%. As to the cases of the Steinthal II. degree, radical mastectomy with resection of the pectoral muscles yielded the 5-year-survival-rate of 34.5% while mastectomy without muscle resection produced the rate of 88.5%. Thus, the latter method gave considerably better results compared with the former.
(3) The postoperative results in the group over 40 years of age were slightly better than those in other age groups. The results were excellent when the primary tumor was under a hen's egg size.
(4) When the tumor adhered with the surrounding tissue, the result of operation with muscle resection was extremely poor. The method without muscle resection yielded very good result in the cases without adhesion, therefore, this method is concidered to be indicated in such cases.
(5) Absence or presence of metastasis of cancer to the axillary lymph nodes influenced the postoperative results markedly. Dissection and cleaning of the axillary lymph nodes should be performed in any case unless a new procedure to confirm the absence of metastasis to the lymph nodes is established.
(6) The radiological treatment plays a important role in improvement of the postoperative results. The effect of complete radiological treatment was remarkable in the cases of the Steinthal II. degree.
(Author's abstract)

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