To the Editor.—We are most appreciative of the comments of Dr. Sanders. We are, of course, very familiar with the modified radical mastectomy. In the mid 1930's a number of radical mastectomies were done without dividing or removing the pectoralis major muscle. It was our impression, perhaps wrongly, that the exposure was not as adequate as when the pectoralis major muscle was removed. We have been pleased with the exposure that we obtain by dividing the muscle, doing the axillary dissection, and then replacing the muscle part way. The functional and cosmetic results have been surprisingly good.