[The usefulness of extended radical mastectomy in patients with breast carcinoma]

Extended radical mastectomy (EXT) in 1, 137 patients with breast carcinoma was devised to eradicate all possible sites of local nodal metastases including internal mammary chain during the years 1962 through 1990. The tumors had to be mainly any T located in medial-half, central (excluding less 1.0 cm or histologic type with good prognosis) and T size measuring 3.0 cm or more in lateral-half. Prognostic outcomes were analysed by the presence or absence of nodes involved. The 10-year relapse free survival in patients with internal mammary node (IMN) only invaded and both axillary (AX) & IMN invaded were 47.8% and 40.1%, respectively. The incidence of relapse free survival at 10 years in relation to the number of positive AX and IMN indicated virtually favorable--1 positive: 71.4%, 2 or 3 positive: 61.3% and 4-9 positive: 53.7%. In our study, the frequency of IMN involvement calculated 24.1% from all quadrants of the breast. In comparison of nonrandomized series with medial-half and lateral-half tumors which involved positive IMN, comprising 95 and 28 patients of the total (n = 495), relapse free survivals at 15 years were 36.5% and 17.5%, respectively. It was presumed that the benefit of EXT would be found in medial-central tumors.