The Japanese journal of surgery

, Volume 13, Issue 1, pp 6–15 | Cite as

Radical mastectomy with intrapleural en bloc resection of internal mammary lymphnode by sternal splitting

  • Masakuni Noguchi
  • Hiroshi Sakuma
  • Akira Matsuba
  • Hajime Kinoshita
  • Koichi Miw
  • Itsuo Miyazaki
Original Communications

Abstract

An operative method of extended radical mastectomy involving intrapleuralen bloc resection of the internal mammary lymphnodes by sternal split was proposed. The operation enables complete resection of axillary and internal mammary lymphnodes. Seventy patients with primary breast cancer underwent the extended operation and two patients with recurence in the internal mammary lymphnode chain following standard radical mastectomy underwent resection of internal mammary lymphnodes by sternal split, with no fatalities and no increase in postoperative disabilities. Metastases to the internal mammary lymphnode chain were histopathologically found in 14 of 70 patients with primary breast cancer and in two with recurrence in the internal mammary lymphnode chain, following standard radical mastectomy; The location of the metastatic internal mammary lymphnodes was from just below the subclavicular vein to the third intercostal space along the internal mammary vessels. Cancer cells were seen not only in the lymphnodes, but also in lymphatics of areolar tissue near the node or in lymphatics between the parietal pleura and endothoracic fascia in patients with primary breast cancer. And cancer invasion to parietal pleura was seen in patients with recurrence in the internal mammary lymphnode chain following standard radical mastectomy. All these findings indicate the rationality of our extended procedures.

Key words

radical mastectomy sternal splitting en bloc resection 

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Copyright information

© The Japan Surgical Society 1983

Authors and Affiliations

  • Masakuni Noguchi
    • 1
  • Hiroshi Sakuma
    • 1
  • Akira Matsuba
    • 1
  • Hajime Kinoshita
    • 1
  • Koichi Miw
    • 1
  • Itsuo Miyazaki
    • 1
  1. 1.Second Department of Surgery, School of MedicineKanazawa UniversityKanazawa, IshikawaJapan

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