J.Jpn. Surg. Soc.. 79(8): 762-765, 1978

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Report on the annual meeting

MODIFICATION OF MUSCLE PRESERVING MASTECTOMY FOR BEAST CANCER: -THE TECHNIQUE AND A STUDY ABOUT AN EFFECTIVENESS OF RAGIONAL LYMPH NODE DISSECTION

Standard radical mastectomy based on the principles established by Haisted and Meyer is now more popular operation in Japan. The main purpose for resection of the pectoralis major muscle in this conventional operation may be not mainly on removal of intramuscular cancer tissues but on complete dissection of regional lymph nodes. A pectoral muscle preserving mastectomy reported by Patey in 1948, and subsequent numerous modified method have been appreciated not only cosmetic and functional advantages over the classical radical operation but also equally satisfactory survival. However this muscle preserving method has not always agained wide acceptance solely for fear of incompleteness of axillary dissection.
A new method has been devided in order to dissolve the repagnance between merits of muscle preservation and complete regional nodes dissection. In this procedure, the pectoralis major muscle is splitted bluntly along the fosse between the clavicular part and the sternocostal part of the muscle that is named “Sulcus interpectoralis”. This fissure is opened enough by retractors and then the pectoralis minor muscle is severed near its attachment to the coracoid process. Thereafter the axillary lymph nodes, especially the subclavicular group which could not been touched by the conventional muscle preserving operation are completely dissected.
This report presents this improved operative technique in detail and ascertains an effectiveness of axillary lymph node dissection with specimens of patients undergone an experimental three steps divided operation.

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