J.Jpn. Surg. Soc.. 80(12): 1477-1480, 1979

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Report on the annual meeting

THE TECHNIQUES OF STANDARD RADICAL MASTECTOMY AND PARASTENAL DISSECTION

In recent years the minor or conservative surgery for early breast cancer has been spread throughout Europe and U.S.A., even in Japan. However, exact evaluation for the conservative procedure is considered to be still controversial.
From the above viewpoint, lymph node dissection in such kind of surgery should be done with basic techniques of standard radical procedure trained well. The author presents the techniques of axillary node dissection in standard radical mastectomy and of parasternal dissection.
The principles of those dissection involves meticulous techniques and a sharp dissection throughout using a scalpel as emphasized originally by Halsted and Haagensen. Range of the dissection of a whole axillary content is from the apical region of infraclavicular fossa just adjacent the proximal end of the axillary vein to the lateral surface of the latissimus dorsi muscle. Parasternal dissection is made from the first inter-space to the forth inter-space. We have experienced 708 cases of axillary dissection and 352 cases of parasternal dissection, and the incidences of node metastases proved histologically were 47.5% and 23.0%, respectively. Improvement of end results in breast cancer treatment may be achieved with thorough radical dissection by such meticulous maneuver and sometimes with postoperative anticancer chemotherapy.

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