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Breast cancer in women over 75 years: is axillary dissection always necessary?
E Näslund1, R Fernstad, S Ekman
1Department of Surgery, Danderyd Hospital, Sweden.
Objective:
To study how the information gained from axillary dissection in women (75 years old or more) with breast cancer influenced postoperative adjuvant treatment.
Design:
Retrospective review of casenotes.
Setting:
University departments of surgery and oncology, Sweden.
Subjects:
166 women (aged 75 years or more) operated on for primary breast cancer between 1980-1989.
Main Outcome Measures:
Type of operation and postoperative therapy given.
Results:
In 138/166 (83%) women axillary dissection was done, but in only 21/59 (36%) of these patients did information gained from the procedure influence the postoperative treatment according to the treatment guidelines for breast cancer. None of the 28 patients who did not undergo axillary dissection were subjected to further operations or radiotherapy for axillary nodal recurrence after a mean follow up of 47 months.
Conclusions:
Axillary dissection should be reserved for local control of disease and for those patients who preoperatively agree to undergo postoperative irradiation or chemotherapy if metastases are found.
