194:'s observation of the existence of malignant metastasis to the chest wall and breast bone via the chain of internal mammary nodes under the sternum and employed an "extended" radical mastectomy that included the removal of the lymph nodes located there and the implantation of radium needles into the anterior intercostal spaces. This line of study was extended by his son, Richard S. Handley, who studied internal mammary chain nodal involvement in breast cancer and demonstrated that 33% of 150 breast cancer patients had internal mammary chain involvement at the time of surgery. The radical mastectomy was subsequently extended by a number of surgeons such as Sugarbaker and Urban to include removal of internal mammary lymph nodes. Eventually, this "extended" radical mastectomy was extended even further to include removal of the supraclavicular lymph nodes at the time of mastectomy by Dahl-Iversen and Tobiassen. Some surgeons like Prudente even went as far as amputating the upper arm
163:
from surgery. In 1943, Haagensen and Stout reviewed over 500 patients who had radical mastectomy for breast cancer and identified a group of patients who could not be cured by radical mastectomy thus developing the concepts of operability and inoperability. The signs of inoperability included ulceration of the skin, fixation to the chest wall, satellite nodules, edema of the skin (peau d'orange), supraclavicular lymph node enlargement, axillary lymph nodes greater than 2.5 cm, or matted, fixed lymph nodes. This contribution of
Haagensen and his colleagues would eventually lead to the development of a clinical staging system for breast cancer, the Columbia Clinical Classification, which is a landmark in the study of biology and treatment of breast cancer.
40:
98:
106:
85:(armpit). Breast cancer is the most common cancer among women. During the early twentieth century it was primarily treated by surgery, when the mastectomy was developed. However, with the advancement of technology and surgical skills in recent years, mastectomies have become less invasive. As of 2016, a combination of
198:
with the mastectomy specimen in an attempt to cure relatively advanced local disease. This increasingly radical progression culminated in the ‘super-radical’ mastectomy which consisted of complete excision of all breast tissue, axillary content, removal of the latissimus dorsi, pectoralis major and
132:
Radical mastectomy involves removing all the breast tissue, overlying skin, the pectoralis muscles, and all the axillary lymph nodes. Skin was removed because the disease involved the skin, which was often ulcerated. The pectoralis muscles were removed not only because the chest wall was involved,
162:
and Meyer's work, it was possible to cure some cases of breast cancer and knowledge of the disease began to increase. Standardized treatments were created, and controlled long-term studies were conducted. Soon, it became apparent that some women with advanced stages of the disease did not benefit
128:
Radical mastectomy was based on the medical belief at the time that breast cancer spread locally at first, invading nearby tissue and then spreading to surrounding lymph ducts where the cells were "trapped". It was thought that hematic spread of tumor cells occurred at a much later stage. Halsted
842:
Fisher, B.; Montague, E.; Redmond, C.; Barton, B.; Borland, D.; Fisher, E. R.; Deutsch, M.; Schwarz, G.; Margolese, R. (June 1977). "Comparison of radical mastectomy with alternative treatments for primary breast cancer. A first report of results from a prospective randomized clinical trial".
182:. Therefore, it was thought that performing wider and more mutilating surgeries that removed a greater number of lymph nodes would result in greater chances of cure. From 1920 onwards, many surgeons performed surgeries more invasive than the original procedure by
199:
minor muscles and dissection of the internal mammary lymph nodes. After retrospective analysis, the extended radical mastectomies were abandoned as these massive and disabling operations proved to be not superior to those of the standard radical mastectomies.
133:
but also because it was thought that removal of the transpectoral lymphatic pathways were necessary. It was also thought, at that time, that it was anatomically impossible to do a complete axillary dissection without removing the pectoralis muscle.
955:
120:
published his work with radical mastectomy from the 50 cases operated at Johns
Hopkins between 1889 and 1894. Willy Meyer also published research on radical mastectomy from his interactions with New York patients in December 1894. The
125:
removal of the breast tissue became known as the
Halsted mastectomy before adopting the title "the complete operation" and eventually, "the radical mastectomy" as it is known today.
143:. The five-year survival rate was 40%, which was twice that of untreated patients. However, post-operation morbidity rates were high as the large wounds were left to heal by
155:. Because surgeons were faced with such large breast cancers that seemed to need drastic treatment methods, the quality of patient life was not taken into consideration.
218:
Zurrida, Stefano; Bassi, Fabio; Arnone, Paolo; Martella, Stefano; Castillo, Andres Del; Martini, Rafael
Ribeiro; Semenkiw, M. Eugenia; Caldarella, Pietro (2011-06-05).
116:
and Meyer were the first to achieve successful results with the radical mastectomy, thus ushering in the modern era of surgical treatment for breast cancer. In 1894,
1279:
693:
Parker, Joe M.; Russo, P. E.; Oesterreicher, D. L. (1952). "Investigation of Cause of
Lymphedema of the Upper Extremity After Radical Mastectomy".
534:"The Technique of Radical Mastectomy: With Special Reference to the Management of the Skin Short Case and the Prevention of Functional Disability"
166:
Today, surgeons rarely perform radical mastectomies, as a 1977 study by the
National Surgical Adjuvant Breast and Bowel Project (NSABP), led by
903:
335:"I. The Results of Operations for the Cure of Cancer of the Breast Performed at the Johns Hopkins Hospital from June, 1889, to January, 1894"
1558:
763:
Fitts WT, Keuhnelian JG, Ravdin IS, Schor S (March 1954). "Swelling of the arm after radical mastectomy; a clinical study of its causes".
1349:
39:
856:
170:, showed that there was no statistical difference in survival or recurrence between radical mastectomies and less invasive surgeries.
1472:
1056:
1039:
965:
1272:
129:
himself believed that cancer spread in a "centrifugal spiral", solidifying this opinion in the medical community at the time.
1440:
1553:
1265:
167:
590:
1305:
1548:
1517:
1512:
191:
183:
159:
140:
136:
117:
113:
1238:
1505:
1040:"Radical mastectomy combined with in-continuity resection of the homolateral internal mammary node chain"
178:
According to the
Halsted-Meyer theory, the major pathway for breast cancer dissemination was through the
1527:
1415:
1387:
591:"Evaluation of skin grafting in the technique of radical mastectomy in relation to function of the arm"
455:
Newmark, J.J. (2016). "No ordinary meeting': Robert McWhirter and the decline of radical mastectomy".
1344:
1320:
1315:
919:
Carey, J.M.; Kirklin, J.W. (1952-10-01). "Extended radical mastectomy: a review of its concepts".
139:
accomplished a three-year recurrence rate of 3% and a locoregional recurrence rate of 20% with no
1120:
657:
144:
151:
was ubiquitous, and arm movement was highly restricted. Thus, chronic pain became a prevalent
1479:
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888:
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649:
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571:
553:
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472:
437:
429:
372:
354:
308:
290:
259:
241:
1195:
PACK, GEORGE T. (1961-11-01). "Interscapulomammothoracic
Amputation for Malignant Melanoma".
1395:
1368:
1257:
1204:
1167:
1151:
1096:
1087:
Urban, J. A. (1964-03-01). "Surgical excision of internal mammary nodes for breast cancer".
1051:
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561:
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506:
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74:
70:
1452:
1410:
1140:"Radical mastectomy with parasternal and supraclavicular dissection for mammary carcinoma"
187:
1208:
97:
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424:
407:
392:
W. Meyer, "An improved method of the radical operation for carcinoma of the breast",
350:
66:
1484:
1124:
220:"The Changing Face of Mastectomy (from Mutilation to Aid to Breast Reconstruction)"
86:
17:
408:"Breast cancer surgery: an historical narrative. Part II. 18th and 19th centuries"
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10.1002/1097-0142(197706)39:6<2827::aid-cncr2820390671>3.0.co;2-i
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10.1002/1097-0142(195309)6:5<969::aid-cncr2820060516>3.0.co;2-5
1024:
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376:
312:
263:
1181:
998:
828:
236:
872:
549:
52:
661:
152:
495:"Developments in the Skin-Grafting Operation for Cancer of the Breast"
1289:
983:"Invasion of Internal Mammary Lymph Nodes in Carcinoma of the Breast"
706:
82:
645:
630:"The sequence of emotional reactions in radical mastectomy patients"
494:
89:
and breast conserving mastectomy are considered optimal treatment.
1373:
104:
96:
69:
by removing the breast and its underlying chest muscle (including
1261:
795:"Surgical Adjuvant Treatment of Locally Advanced Breast Cancer"
277:
Plesca M, Bordea C, El
Houcheimi B, Ichim E, Blidaru A (2016).
457:
The
Journal of the Royal College of Physicians of Edinburgh
793:
Townsend, Courtney; Abston, Sally; Fish, Jay (May 1985).
499:
JAMA: The Journal of the American Medical Association
921:
Proceedings of the Staff Meetings of the Mayo Clinic
1493:
1426:
1296:
589:Neumann, Charles G.; Conway, Herbert (1948-01-01).
279:"Evolution of radical mastectomy for breast cancer"
32:
887:
406:Sakorafas, G.h.; Safioleas, Michael (2010-01-01).
894:. New York, NY: Simon & Schuster. pp.
1138:Dahl-Iversen, E.; Tobiassen, T. (1969-12-01).
981:Handley, R. S.; Thackray, A. C. (1954-01-09).
1273:
8:
954:Schachter, Karen; Neuhauser, Duncan (1981).
1280:
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1258:
224:International Journal of Surgical Oncology
38:
1171:
1055:
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818:
669:
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253:
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493:HALSTED, WILLIAM STEWART (1913-02-08).
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29:
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7:
1209:10.1001/archsurg.1961.01300170050010
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213:
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65:is a surgical procedure that treats
1350:Trans-umbilical breast augmentation
1288:Tests and procedures involving the
48:
333:Halsted, William S. (1894-11-01).
25:
1473:Automated whole-breast ultrasound
728:JR, VON RONNEN (1955-01-01). "".
1156:10.1097/00000658-196912000-00006
1038:Sugarbaker, E. D. (1953-09-01).
811:10.1097/00000658-198505000-00009
511:10.1001/jama.1913.04340060008004
425:10.1111/j.1365-2354.2008.01060.x
351:10.1097/00000658-189407000-00075
412:European Journal of Cancer Care
1089:The British Journal of Surgery
886:Mukherjee, Siddhartha (2011).
1:
1441:Positron emission mammography
532:Riddell, V. H. (2017-04-21).
396:, vol. 46, pp. 746–749, 1894.
174:Extended radical mastectomies
1559:Surgical removal procedures
890:The Emperor of All Maladies
730:Journal Belge de Radiologie
628:Bard, Morton (2017-04-21).
101:Portrait of William Halsted
27:Removal of cancerous breast
1575:
1239:"Super Radical Mastectomy"
1306:Breast-conserving surgery
957:Surgery for breast cancer
538:British Journal of Cancer
49:
37:
1518:Breast self-examination
1513:Breast cancer screening
987:British Medical Journal
394:New York Medical Record
141:perioperative mortality
1506:Fine-needle aspiration
1101:10.1002/bjs.1800510311
851:(6 Suppl): 2827–2839.
469:10.4997/jrcpe.2016.110
110:
102:
1528:Breast duct endoscopy
1416:Central duct excision
1394:Interventions on the
1388:Breast reconstruction
1243:TheFreeDictionary.com
999:10.1136/bmj.1.4853.61
634:Public Health Reports
108:
100:
960:. DIANE Publishing.
158:Nonetheless, due to
1345:Breast augmentation
1321:Wide local excision
1316:Segmental resection
1197:Archives of Surgery
550:10.1038/bjc.1950.27
237:10.1155/2011/980158
18:Mastectomy, radical
1338:Radical mastectomy
111:
103:
93:Radical mastectomy
63:Radical mastectomy
44:Radical Mastectomy
33:Radical mastectomy
1554:Surgical oncology
1536:
1535:
1480:Scintimammography
1468:Breast ultrasound
1396:Lactiferous ducts
1144:Annals of Surgery
905:978-1-4391-0795-9
640:(11): 1144–1148.
339:Annals of Surgery
60:
59:
16:(Redirected from
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1369:Breast reduction
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1059:
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978:
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707:10.1148/59.4.538
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619:
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579:
569:
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109:Pectoralis Major
75:pectoralis minor
71:pectoralis major
53:edit on Wikidata
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1453:Xeromammography
1422:
1411:Microdochectomy
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1193:
1189:
1137:
1136:
1132:
1086:
1085:
1081:
1037:
1036:
1032:
993:(4853): 61–63.
980:
979:
975:
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953:
952:
948:
918:
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885:
884:
880:
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180:lymphatic ducts
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137:William Halsted
118:William Halsted
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1428:Breast imaging
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1364:Breast implant
1355:
1354:
1353:
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1340:
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1329:
1328:
1326:Quadrantectomy
1323:
1318:
1313:
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1300:
1298:Breast surgery
1294:
1293:
1287:
1285:
1284:
1277:
1270:
1262:
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1230:
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1095:(3): 209–212.
1079:
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1483:
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1471:
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1458:Galactography
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1449:
1448:Tomosynthesis
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1434:
1433:
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1401:Ductal lavage
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736:(4): 525–34.
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67:breast cancer
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1246:. Retrieved
1242:
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527:
502:
498:
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460:
456:
450:
415:
411:
401:
393:
342:
338:
289:(2): 183–6.
286:
282:
272:
227:
223:
195:
177:
165:
157:
135:
131:
127:
122:
112:
87:radiotherapy
62:
61:
1436:Mammography
1359:Mammaplasty
418:(1): 6–29.
145:granulation
79:lymph nodes
1543:Categories
1463:Breast MRI
1406:Ductoscopy
1333:Mastectomy
1311:Lumpectomy
1248:2017-04-02
505:(6): 416.
283:J Med Life
230:: 980158.
203:References
149:lymphedema
1383:Mastopexy
1217:0004-0010
1164:0003-4932
1109:0007-1323
1066:0008-543X
1007:0007-1447
933:0092-699X
865:0008-543X
742:0302-7430
695:Radiology
654:0094-6214
607:0039-6060
558:0007-0920
519:0002-9955
434:1365-2354
359:0003-4932
295:1844-3117
246:2090-1402
1225:14483062
1117:14129436
1074:13094645
1025:13106471
941:13004011
799:Ann Surg
777:13146467
750:13331884
715:12983584
680:12993982
615:18906044
576:14783660
477:27092369
442:19674073
377:17860107
313:27453752
264:22312537
1182:5352643
1173:1387715
1125:5680572
1016:2093179
896:200–201
829:3994434
820:1250769
765:Surgery
671:2030852
662:4588308
595:Surgery
567:2007674
368:1493925
304:4863512
255:3263661
196:en bloc
192:Halsted
184:Halsted
160:Halsted
153:sequela
123:en bloc
114:Halsted
81:of the
77:), and
1290:breast
1223:
1215:
1180:
1170:
1162:
1123:
1115:
1107:
1072:
1064:
1044:Cancer
1023:
1013:
1005:
964:
939:
931:
902:
873:326381
871:
863:
845:Cancer
827:
817:
775:
748:
740:
713:
678:
668:
660:
652:
613:
605:
574:
564:
556:
517:
475:
440:
432:
375:
365:
357:
311:
301:
293:
262:
252:
244:
190:noted
83:axilla
1494:Other
1374:SPAIR
1121:S2CID
658:JSTOR
51:[
1221:PMID
1213:ISSN
1178:PMID
1160:ISSN
1113:PMID
1105:ISSN
1070:PMID
1062:ISSN
1021:PMID
1003:ISSN
962:ISBN
937:PMID
929:ISSN
900:ISBN
869:PMID
861:ISSN
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738:ISSN
711:PMID
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430:ISSN
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309:PMID
291:ISSN
260:PMID
242:ISSN
228:2011
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1205:doi
1168:PMC
1152:doi
1148:170
1097:doi
1052:doi
1011:PMC
995:doi
853:doi
815:PMC
807:doi
803:201
703:doi
666:PMC
642:doi
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546:doi
507:doi
465:doi
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