Inefficacy of internal mammary nodes dissection in XXXX surgery.

@entity1 @entity5 @entity0
From January 1964 to January 1968, 737 @entity1 with @entity0 were randomized at the @entity5 Institute in Milan to undergo either Halsted mastectomy or Halsted mastectomy with internal mammary node dissection; 716 were considered evaluable. The series was part of an international cooperative study. The two groups of @entity1 were comparable in age, menopausal status, quadrant distribution, and frequency of axillary metastases. No @entity1 received postoperative radiotherapy or adjuvant treatments. At ten years, no difference was found in either in the length of disease-free or overall survival in the two series. The overall survival was 60.7% in @entity1 treated with Halsted mastectomy and 57.0% in @entity1 treated with Halsted mastectomy plus internal mammary dissection. In no subgroups was a statistically significant difference found. In the series treated by extended mastectomy, the incidence of internal mammary metastases was 20.5% (24.6% in cases with @entity5 in medial or central quadrants and 17.7% in cases with @entity5 in lateral quadrants). The follow-up of the @entity1 treated by Halsted mastectomy showed that only 15 had a parasternal recurrence; the expected number was 75. In nine @entity1 , parasternal recurrences were the first site of relapse of the disease. All of them were treated with radiotherapy, and in four a complete control was obtained.
