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In answer, it is assumed that every responsible surgeon will attempt to do the best he can for each individual patient, but, implied also, is a motivation that will urge him to accomplish the best that can be done for all of his patients. It is the author's opinion that the matter of extended mastectomy has been opened more widely but not closed by the paper presented. In fact, the early part of the communication implies that others are attempting to deal with this problem in a variety of ways, and many will, in all likelihood, eventually be heard. The point of the matter appears to involve one's concept regarding the relationship of primary draining lymphatic beds to the curability of cancer and their accessibility to removal.
Regarding selection of cases, there appears to be a misunderstanding. Concerning the approximate 10% operated on in the conventional manner during the era
Sugarbaker ED. Mastectomy Statistics-Reply. JAMA. 1964;188(5):472. doi:10.1001/jama.1964.03060310072021