For some reason, I see and hear radical mastectomy referenced relatively frequently even though Western surgeons abandoned this operation sixty years ago. I mention it here to be thorough, respectful to the surgery giants who paved the road to where we are now, and to develop the mastectomy concept.
In a radical mastectomy, the entire breast including the skin, all the axillary (arm pit) lymph nodes and the pectoralis minor muscle are removed. The pectoralis major muscle is not removed. In the past, skin grafts were often necessary to close the wound.
I have performed this operation only a handful of times in patients with locally advanced disease but I have taken care of quite a few women who had this operation back in the day, including a lovely lady who is currently my patient and had this operation when she was 24 years old. It is a wildly disfiguring procedure and can cause significant problems with arm movement and lymphedema.
The surgical giants at the time knew about these potential problems but the operation was still performed because the thinking at the time was that mammary carcinoma spread logically through contiguous lymphatic systems and that removing the soft tissue containing the lymphatic vessels would halt the process
Careful observation showed relatively quickly that this was not the case so the operation was modified.
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