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January 8, 1938


JAMA. 1938;110(2):130-132. doi:10.1001/jama.1938.02790020044015

Fundamental in the surgical treatment of a malignant neoplasm is the widest possible removal of the primary growth together with its regional metastases. The standardized radical operation for cancer of the breast may be said to date from the publication in 1894 by William Stewart Halsted of his method. The operation included a careful clearance of the axillary contents, the removal of the supraclavicular lymph nodes, and the removal of the breast and of the pectoralis major muscle. In the later modification of the Halsted operation the dissection of the supraclavicular lymph nodes is omitted, but emphasis is placed on the removal of both pectoral muscles and the widest possible removal of the skin and fascia, frequently necessitating skin grafting to complete the healing of the denuded area. Obviously it would be impossible to go further in the direction of radical surgery.

While statistics accumulated in the course of the

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