In 1979, Modified radical mastectomy replaced radical mastectomy for breast cancer. The standard of care for patients with stage I/II breast cancer is lumpectomy or a more extended resection like quadrantectomy, followed by whole breast irradiation.

Radical mastectomy involves the removal of all breast tissue, overlying skin, and both pectoralis muscles, together with complete en bloc removal of the axillary lymph nodes. Skin was removed because the disease often involved the skin; in fact, the skin was often ulcerated on presentation. The pectoralis muscles were removed not simply because the chest wall was often involved, but because it was considered essential to remove the transpectoral lymphatic pathways that run directly through the pectoralis major to Rotter’s nodes between the pectoralis major and pectoralis minor.

These new mastectomies provided results that are oncologically equivalent to the older operations but make it easier to perform immediate breast reconstructions that achieve good aesthetic results and reduce psychological morbidity. At the same time, mastectomy has been supplanted by surgical approaches that conserve the breast for a large fraction of breast cancer patients in Western countries, in part because breast cancer is diagnosed at a much earlier stage.