ABSTRACT
Anatomists proposed in the 17th century that cancer spread from primary tumors to regional lymph nodes.1 By the end of the 19th century, surgical and anesthetic techniques improved to allow major surgical procedures for patients with cancer.William Halsted pioneered radical mastectomy and axillary lymphadenectomy to treat patients with breast cancer.The operation was designed to remove the tumor, primary organ, regional lymph nodes, and intervening skin, fat, and lymphatic channels. Widespread application of this approach resulted in dramatically improved survival outcomes; however, short-and long-term morbidity was high. This was considered an acceptable alternative to a slow, agonizing death from a locally advanced tumor.
