INDICATIONS FOR MODIFIED RADICAL MASTECTOMY

Radical mastectomy was performed on 248 patients with primary breast cancer at our clinic over a period of nine years. The relationship between the size of the primary tumor and lymph node metastases was evaluated in 71 Stage 1 patients. n1α was seen in five (11.9%) out of 42 patients with primary tumors measuring 1.1-2.0cm, whereas n1β was found in one (3.4%) out of 29 patients with primary tumors measuring 1.0cm or less. Accordingly, it is considered that modified radical mastectomy should be performed on those patients whose tumors measure 1.0cm or less. S-shaped skin incisions were performed on patients with early cancer in which the lesion was located in the marginal region of the mammary gland. The number of patients with skin graft was reduced as compared with the conventional Meyer method or Stewart method. The lymphodynamics were evaluated with lymphoscintigram by Tc-99m-human serum albumin. All ten subjects of the control group exhibited the parasternal type. Out of 25 patients of the breast cancer group, 21 (81.4%) presented the parasternal type, four (19.6%) the axillary type, and no one the infraclavicular type. The values (T1/2) of the clearance curve were 85.6 minutes for the control group and 44.4 minutes for the breast cancer group. Thus, lymphatic flow indicated a difference between the cancer-bearing breast and the normal breast.