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RATIONALE OF INTERNAL MAMMARY LYMPH NODE DISSECTION FOR CARCINOMA OF THE BREAST

DONALD M. GLOVER, M.D.
AMA Arch Surg. 1954;69(3):393-399. doi:10.1001/archsurg.1954.01270030121011.
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HALSTED* laid the cornerstone for the effective treatment of carcinoma of the breast by stressing the importance of removal of the entire breast and overlying skin, the pectoral muscles with their fascial envelopment, and the regional lymphatics and lymph nodes. He recognized the supraclavicular extension from the axilla and included resection of the nodes in the latter area as a part of the radical operation in 101 cases included with his published report of 1907. He also predicted that in the future the removal of the mediastinal lymph nodes would probably become a part of the usual operative procedure. He apparently regarded the added operative trauma of the supraclavicular dissection as of questionable virtue, since only 2 of the 44 patients in whom the nodes were found to be involved were cured for five years or more. That fact probably discouraged extending the operation to include the mediastinal nodes, which

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