To the Editor.—Recently, my attention was directed to an otherwise excellent article by Robert H. Yonemoto, MD, et al, entitled "Complete Axillary Node Dissection With Preservation of the Pectoralis Major Muscle," in the June issue of the Archives (102:578-581, 1971).
In describing their operative technique, the authors state, the muscle (eg, pectoralis major) is split parallel to its fiber between the clavicular and sternal portions, preserving the cephalic vein, and then severed through the tendinous portion, near the bicipital groove.
I wish to point out that it is never necessary to transect the pectoralis major muscle in order to perform an anatomically complete axillary dissection. In performing the modified radical mastectomy described by David Patey and Richard Handley of the Middlesex Hospital, London, England, an oncologically complete and satisfactory axillary dissection is regularly done by mobilizing this muscle, relaxing it by elevating the homolateral arm and attaching it to