Modified radical mastectomy with immediate breast reconstruction.

Surgery for breast cancer continues to evolve. Less radical procedures and increasing concern about appearance and rehabilitation are now the trend. Such considerations prompted a detailed anatomic study and review of the location and course of the medial and lateral pectoral nerves, the development of a technique for immediate reconstruction of the breast during modified radical mastectomy that protects the innervation of the pectoral muscles and incorporates them in the construction of a submuscular pocket to receive a silicone breast prosthesis, and the administration of low doses of heparin sodium to prevent necrosis of ischemic breast flaps. Fifty immediate reconstructions of the breast after modified radical mastectomy were performed in 48 women with carcinoma of the breast. We believe this procedure greatly enhances rehabilitation and quality of life without diminishing the ability to diagnose or treat recurrent disease.