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October 7, 1974

Management of Breast Cancer: Limited Mastectomy

Author Affiliations

From the Department of General Surgery, the Cleveland Clinic Foundation, and the Cleveland Clinic Educational Foundation, Cleveland.

JAMA. 1974;230(1):95-98. doi:10.1001/jama.1974.03240010061039

MY stand on the treatment of breast cancer has been widely misunderstood. Many surgeons believe that I advocate what the British call "lumpectomy" and irradiation. Nothing could be further from the truth. I do, however, stand firmly against the traditional radical mastectomy. I consider it to be archaic, and I believe that it has no place in the modern treatment of breast cancer.

I strongly support modified radical mastectomy. It is primarily indicated for a patient who, at the time of operation, has palpable involvement of a few low or central axillary nodes. If the involvement is extensive, however, and particularly if the nodes at the apex are palpably involved, I agree with Haagenson that the axilla should not be dissected. It is better to rely on irradiation to control the cancer in the apical, supraclavicular, and internal mammary nodes.

In patients who at the time of operation have no