Even though Halsted's radical mastectomy was described as early as 1890, to now little progress has been made in the control of carcinoma of the breast, either by surgery or by more conservative means. A radical mastectomy of the Halsted type has significant benefit only in that group of patients in which the spread of cancer is confined to the removable tissue of the chest wall and axilla. The diverse modifications of conventional surgery seen today reflect discontent with the results of the radical mastectomy, but even the modifications effect local control of the tumor rather than the ultimate cure.
The principle of adjuvant cancer chemotherapy with surgical resection is based on the following: Destruction of implanted carcinoma in experimental animals can be achieved by subtotal resection of the tumor if alkylating agents are given at the time of resection. In such instances, the "cure" rate is inversely proportional to