[Axillary lymph node metastases in breast cancer. Anatomo-clinical correlation and surgical approach]

To establish the incidence of the axillary lymph node metastasis in breast cancer and some anatomo-clinical correlations useful for surgical act orientation.

The data from 450 patients, who underwent surgery for breast cancer between 2000 and 2007, were analyzed statistically according to some parameters: the age of the patients, the size and the location of the tumor, the hystopathological type, the elapsed time from the discovery of the tumor until surgery.

The tumoral stage was: stage 0--1.1%, I--7.11%, II--50.67%, III--33.78%, IV--7.33%. From the total amount of patients who underwent surgery, only 56.44% had axillary lymph node metastasis. The patients in the forth decade of life had more frequently axillary lymph node involvement, and also those from rural habitat (65.88%). The correlation between tumor dimension and lymph node involvement was: <2 cm--1.36%, 2-5 cm--48.71%, >5 cm--86.67%. The palpation of the armpit was associated in almost a quarter of cases with false negative or false positive diagnosis. There are a lot of locally advanced cases without axillary lymph node metastases.

Axillary lymph node status is strongly correlated with the tumor dimension and the elapsed time between diagnosis and treatment. The numerous cases of axillary lymphadenectomy without lymph node metastases (43.55%), even in locally advanced cases, advocate for a wider application of lymphatic mapping and sentinel lymph node biopsy, to avoid the pathology associated with those axillary dissections.