INDICATIONS IN CA.BREAST- LARGE TUMOR IN SMALL BREAST CENTRAL TUMORS MULTIFOCAL DISEASE LOCAL RECURRENCE PATIENT PREFERENCE
POSITION SUPINE POSITION ARM ABDUCTED PILLOW UNDER THE SHOULDER
ANAESTHESIA GENERAL THORACIC EPIDURAL
INCISION ELLIPTICAL INCISION ENCIRCLING THE TUMOR AND NIPPLE AREOLA COMPLEX AXIS OF ELLIPSE DEPENDS ON SITE OF TUMOR TRANSVERSE ELLIPSE IS USUALLY SUFFICIENT
PROCEDURE SKIN FLAPS ARE RAISED UPTO CLAVICLE AND COSTAL MARGIN EN BLOC DISSECTION OF: BREAST WITH TUMOR AND NIPPLE PECTORALIS MAJOR PECTORALIS MINOR AXILLARY FAT,LYMPHATICS,NODES WOUND DRAINED SKIN CLOSED
STRUCTURES PRESERVED AXILLARY VIEN CEPHALIC VEIN NERVE TO SERRATUS NERVE TO LATISSIMUS