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The value of axillary dissection in T1a breast cancer
J M McGee1, R Youmans, F Clingan
1Department of Surgery, University of Oklahoma College of Medicine, Tulsa 74129, USA.
Background:
Some authors have stated the undesirability of axillary lymph node dissections for very small breast cancers, because so few of their patients have lymph node metastases (3% for T1a lesions in one series).
Methods:
Of 6,308 breast cancer cases reviewed from three large urban hospitals 3,077 single primary cases with both axillary dissection and accurate tumor measurements were statistically analyzed.
Results:
For T1a lesions we found axillary metastases to be four times higher (12%) than others have reported. For each tumor size there was a statistically significant difference in the percentage of axillary metastases. There was also a statistically significant difference in the breast cancer-specific survival of patients with different tumor sizes (n = 3,077) at the 3-year, 5-year, 7-year, and 10-year periods.
Conclusion:
These results justify axillary node dissections even for very small invasive cancers of the breast, particularly for invasive ductal histology.