Abstract
Based on a thorough knowledge of the breast cancer biology, surgical management of breast cancer has become more conservative. Most of the previous prospective randomized studies also showed that extended radical mastectomy did not improve survival of the patients. However, several reports suggested that a small number of patients with axillary node-negative and parasternal node-positive had a higher survival rate after extended radical mastectomy compared to radical mastectomy. The means to obtain this information is at present not satisfactory. Therefore, several authors avocate the limited usefulness of extended radical mastectomy in a staging operation. Even in these surgical procedures, combination with systemic therapy is essential.
