Modified radical mastectomy: definition and role in breast cancer surgery.

The reasons for the dramatic change during the past decade in the United States regarding the surgical treatment of patients with potentially curable invasive breast cancers from the classical radical mastectomy to the modified radical mastectomy are discussed. The various types of modified radical mastectomy are described and the indications for their use as part of a moderate selective surgical approach to breast cancer are discussed in detail. The results obtained in 846 patients with potentially curable breast cancers who were followed for ten years or more are presented: 80.3% had less than a radical mastectomy including an absolute, no evidence of disease, survival rate of 63% and a local recurrence rate of 7.8%, along with ease of breast reconstruction when the pectoralis major muscle is preserved. These results, as compared to those obtained with other types of surgical approach and with primary radiotherapy, offer a most favorable comparison.