[Axillary dissection in cancer of the breast: a conservative approach]

It is common in oncology to have more than one alternative treatment for the same clinical situation. This is particularly true in breast cancer. Traditional treatments such as Halsted Radical Mastectomies are difficult to change. It is not uncommon to see this approach in Brazil, even in initial tumors, although it is considered unnecessary unless the pectoralis muscle is involved. Radical dissection of the axilla is another controversial issue in breast cancer today. Recent publications have given support to question the routine recommendation of axillary dissection in breast cancer. It is reasonable, under certain circumstances, not to perform axillary dissection or treat the axilla with other methods. Limited axillary dissection, for instance, may present good results with less risk of arm lymphedema. This paper illustrates this point showing preliminary results of 147 breast cancer patients with local tumor treated with conservative management. Half of the patients (74) had axillary surgery while the other 73 did not. Multivariate analysis using Cox's regression was performed and showed that axillary dissection did not change survival. This information confirms similar data published in the literature.