Axillary dissection can be avoided in selected breast cancer patients: analysis of 401 cases

The role of axillary dissection in early breast cancer remains controversial because of its uncertain value with respect to disease free and overall survival. 401 breast cancer patients underwent breast surgery without axillary dissection from January 1986 to June 1994. 323 (81%) patients were postmenopausal whereas 78 (19%) were premenopausal status, the mean age was 62.9 years. 216 out of 401 patients (53.6%) had a pathological tumour < or = 1 cm, 133 (33.6%) were between 1 and 2 cm, whereas 38 (9.5%) had a tumour size > 2 cm. Breast conservative surgery was performed in 383 patients (95.6%), 257 patients (64.1%) received radiotherapy to the operated breast. In elderly patients adjuvant hormonotherapy was preferred considering the hormonal receptorial status. Accurate follow-up showed that 25 patients underwent delayed full axillary dissection, and pathological metastases were determined in 19 cases, so that the total rate of axillary relapses, histologically confirmed, was 4.7%. We conclude that axillary surgery can be avoided in selected breast cancer patients.