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Optimal management of the axilla in patients with breast cancer
E Shin1, Y Minami, Y Takatsuka
1Department of Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chyuo-ku, Osaka 540-0006, Japan.
Background:
Although most surgeons perform some form of axillary lymph node dissection (ALND) as part of locoregional management of operable breast cancer, the extent of dissection remains controversial.
Patients And Methods:
Observation of the axilla trial (protocol I) and partial dissection trial (protocol I) began in January 1996. Between January 1996 and May 2000, 45 post-menopausal and 207 women with clinically node-negative breast cancer were enrolled into protocol I and protocol II respectively.
Results:
The 4-year cumulative incidence rate of axillary recurrence was 7% in patients with untreated the axilla. The 4-year overall survival rate was 98% in patients with untreated the axilla. The 4-year disease-free and overall survival rates were 96% and 98% respectively in patients treated with partial dissection.
Conclusion:
Total axillary dissection seems to be unnecessary in Japanese breast cancer patients with relatively small tumors.