Extended Radical Mastectomy with Removal of Axillary,Internal Mammary,Supraclavicular and Mediastinal Lymph Nodes

Description of the technique of super-radical mastectomy with removal of axillary, internal mammary, supraclavicular and mediastinal lymph nodes developed at the National Cancer Institute of Milan and previously reported (1). The thoracic defect due to thoracectomy with removal of the clavicle, the medial portion of the first and second ribs and the corresponding half of the sternum is now avoided by sternal replacement and suture. Thus radicality is maintained and cosmetic impairment is confined to breast removal.