{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T20:39:49Z","timestamp":1789850389734,"version":"4.0.1"},"reference-count":18,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2004,1,1]],"date-time":"2004-01-01T00:00:00Z","timestamp":1072915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In addition to mastectomy, level II and level III axillary node dissection procedures are performed widely in Japan. A randomized clinical trial was performed to determine which procedure was more effective.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>One group of women had resection of the pectoralis minor muscle and dissection of level I, II and III axillary lymph nodes (level III dissection). In a second group, the pectoralis minor muscle was left intact and level III axillary lymph node dissection was not performed (level II dissection). A total of 1209 women with stage II breast cancer were enrolled in the study and randomly assigned to one of the two groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The 10-year cumulative survival rate was 86\u00b76 per cent after level II and 85\u00b77 per cent after level III axillary dissection (hazard ratio (HR) 1\u00b702; P = 0\u00b7931, log rank test). The 10-year disease-free survival rate was 73\u00b73 and 77\u00b78 per cent respectively (HR 0\u00b794, P = 0\u00b7666). Overall survival and disease-free survival rates in the two groups were similar after both procedures. The duration of surgery was significantly shorter (P &amp;lt; 0\u00b7001) and blood loss was significantly less (P = 0\u00b7001) after level II dissection. In a survey of patients' symptoms on follow-up, no significant differences were found between the two procedures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The addition of pectoralis minor muscle resection and level III axillary lymph node dissection to mastectomy for stage II breast cancer did not improve overall or disease-free survival rates.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.4372","type":"journal-article","created":{"date-parts":[[2004,1,6]],"date-time":"2004-01-06T08:00:38Z","timestamp":1073376038000},"page":"38-43","source":"Crossref","is-referenced-by-count":28,"title":["Randomized clinical trial comparing level II and level III axillary node dissection in addition to mastectomy for breast cancer"],"prefix":"10.1093","volume":"91","author":[{"given":"T","family":"Tominaga","sequence":"first","affiliation":[{"name":"Breast Cancer Centre, Toyosu Hospital, Showa University School of Medicine , 4-1-18 Toyosu, Koutou-ku, Tokyo 135-8577,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Takashima","sequence":"additional","affiliation":[{"name":"Breast Cancer Centre, Toyosu Hospital, Showa University School of Medicine , 4-1-18 Toyosu, Koutou-ku, Tokyo 135-8577,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Danno","sequence":"additional","affiliation":[{"name":"Breast Cancer Centre, Toyosu Hospital, Showa University School of Medicine , 4-1-18 Toyosu, Koutou-ku, Tokyo 135-8577,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2004,1,1]]},"reference":[{"key":"2024093006360110500_bib1","first-page":"239","article-title":"Radical versus modified radical mastectomy for breast cancer","volume":"63","author":"Turner","year":"1981","journal-title":"Ann R Coll Surg Engl"},{"key":"2024093006360110500_bib2","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/00000658-198308000-00016","article-title":"A randomized prospective trial of radical (Halsted) mastectomy versus modified radical mastectomy in 311 breast cancer patients","volume":"198","author":"Maddox","year":"1983","journal-title":"Ann Surg"},{"key":"2024093006360110500_bib3","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1097\/00000658-197905000-00003","article-title":"A comparison of modified radical mastectomy to radical mastectomy in the treatment of operable breast cancer","volume":"189","author":"Baker","year":"1979","journal-title":"Ann Surg"},{"key":"2024093006360110500_bib4","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1016\/0277-5379(86)90011-8","article-title":"Comparison of Halsted mastectomy with quadrantectomy, axillary dissection, and radiotherapy in early breast cancer: long-term results","volume":"22","author":"Veronesi","year":"1986","journal-title":"Eur J Cancer Clin Oncol"},{"key":"2024093006360110500_bib5","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1056\/NEJM198503143121101","article-title":"Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer","volume":"312","author":"Fisher","year":"1985","journal-title":"N Engl J Med"},{"key":"2024093006360110500_bib6","doi-asserted-by":"crossref","first-page":"1456","DOI":"10.1056\/NEJM199511303332203","article-title":"Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer","volume":"333","author":"Fisher","year":"1995","journal-title":"N Engl J Med"},{"key":"2024093006360110500_bib7","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/0277-5379(90)90114-9","article-title":"Quadrantectomy versus lumpectomy for small size breast cancer","volume":"26","author":"Veronesi","year":"1990","journal-title":"Eur J Cancer"},{"key":"2024093006360110500_bib8","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00000658-196307000-00008","article-title":"Significance of location and number of axillary metastasis in carcinoma of the breast. 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