Murakami T, Sunagawa M, Takahashi I, Hayashi K
Jpn J Surg. 1975 Jun;5(2):84-91. doi: 10.1007/BF02469612.
A new technique of modified radical mastectomy for early breast cancer was devised with an express purpose of preserving pectoralis major muscle but still enabling radical removal of the regional lymphnodes. The pectoralis major muscle was transected at its midportion to expose the thoracic wall for radical dissection of axillar and subclavicular lymphnodes followed by resuturing of the muscle to preserve its continuity. The parasternal nodes can also be dissected if necessary. The pectoralis minor muscle is either resected or preserved. This procedure should be applied mainly in T1N0 and T1N1a (Stage I in the TNM staging system) which seems recently to be increasing rapidly in number and for which the radical mastectomy with resection of pectoralis major muscle is thought to be too excessive. The procedure proposed in the present communication offers advantage not only in functional but also cosmetic aspect by preserving the pectoralis major muscle while the radicality of the operation is retained. Although the number of cases thus treated is limited and the long-term follow up with survival rate is not yet available, the procedure seems to be of considerable value in selected patients.
一种用于早期乳腺癌的改良根治性乳房切除术新技术被设计出来，其明确目的是保留胸大肌，但仍能彻底清除区域淋巴结。胸大肌在其中部横断，以暴露胸壁，以便对腋窝和锁骨下淋巴结进行根治性清扫，随后将肌肉重新缝合以保持其连续性。如有必要，也可清扫胸骨旁淋巴结。胸小肌可切除或保留。该手术主要适用于T1N0和T1N1a（TNM分期系统中的I期），近年来这类病例的数量似乎在迅速增加，而认为切除胸大肌的根治性乳房切除术过于激进。本文提出的手术不仅在功能方面，而且在美容方面都具有优势，因为在保留手术根治性的同时保留了胸大肌。尽管接受这种治疗的病例数量有限，且尚未有长期随访及生存率的数据，但该手术在选定的患者中似乎具有相当大的价值。
