Prognostic factors and management of axillary node negative breast cancer

Axillary node negative breast cancer has become the most frequently occurring stage of breast cancer among American women. Even in spite of early diagnosis and optimal local management, 20-30 percent of all women diagnosed with Stage I breast cancer will recur and succumb to the disease. Standard management approaches to treatment as well as prognostic determinants are in a state of rapid evolution. Entry of patients to appropriate clinical trials is highly recommended. However, if this option is not available to the physician or is not desired by the patient, further therapeutic approaches must be guided by the prognostic variables. For patients with small (less than 1 cm) tumors, low nuclear grade and/or low proliferation rate with diploid DNA characteristics, no further therapy may be a reasonable option. However, patients with tumors equal or greater than 2 cm, high or poor nuclear grade, with a high proliferation rate and aneuploid tumor should be considered candidates for adjuvant chemotherapy if the tumor is ER negative, or treatment with tamoxifen if the tumor is ER positive.