Modified Radical Mastectomy

Abstract

Indications Invasive breast cancer with axillary lymph node metastasis Essential Steps 1. Review patient information to ensure proper indications and laterality of operation. 2. Create an elliptical incision over the breast encompassing the nipple-areolar complex and biopsy scar. 3. Raise flaps in the avascular plane between the subcutaneous and breast tissues. Dissect: (a) Superiorly to the clavicle (b) Medially to the sternum (c) Inferiorly to the superior aspect of the anterior rectus sheath/inframammary fold (d) Laterally to the anterior border of the latissimus dorsi 4. Remove all the breast tissue, including the pectoralis fascial, from the chest wall. If tumor extension is noted into the pectoralis muscle, remove the tumor en bloc with a surrounding disk of muscle.