Role of axillary dissection in mammographically detected breast cancer

The traditional rationale for axillary lymphadenectomy in patients with breast cancer was that the procedure was therapeutic, diagnostic, and needed to determine adjuvant therapy. Recent data have shown that there is little, if any, therapeutic value to this procedure and that the decision to use adjuvant chemotherapy or hormonal therapy may no longer be absolutely contingent on axillary node status. Increasingly, primary tumor factors are being used to establish the aggressiveness of cancers. Therefore, the widespread use of axillary lymphadenectomy especially in small, mammographically detected breast cancers is questioned.