Indications for axillary dissection in T1 breast cancer

Mustafa, Isha A.; Bland, Kirby I.

doi:10.1007/bf02303756

Cited by 26 publications

(12 citation statements)

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“…ALND is associated with a significant postoperative morbidity such as arm pain, arm lymphedema and shoulder stiffness (19), and it does not improve the long-term survival for patients with small breast cancers (7,10). In our study, ALND significantly increased the incidence of arm lymphedema (37.0 vs 7.1%, P ¼ 0.030).…”

Section: Discussionsupporting

confidence: 50%

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The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

Lee

Suh

Shim

et al. 2011

Japanese Journal of Clinical Oncology

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Objective: This study was designed to evaluate the rate and the predictors of axillary lymph node metastasis in patients with T1mi breast cancer. Methods: We analyzed 62 cases of ductal carcinoma in situ with microinvasion, and the pathology records and treatment charts were retrospectively reviewed for information on the patient and tumor characteristics. All the included patients underwent breast conserving surgery and 48 patients underwent axillary lymph node dissection. Results: The incidence of axillary involvement was 8.3%. Comedo ductal carcinoma in situ (P ¼ 0.031), histologic grade 3 (P ¼ 0.025), the presence of necrosis (P ¼ 0.007) and Van Nuys group 3 (P ¼ 0.025) were significant predictors of axillary involvement on the statistical analysis. Axillary dissection was significantly associated with the occurrence of arm lymphedema (P ¼ 0.030). Conclusions: A significant rate of axillary metastases occurred in the patients with T1mi breast carcinoma in this study. The comedo subtype of ductal carcinoma in situ, a high histologic grade, the presence of necrosis and the Van Nuys group 3 were significant predictors of axillary lymph node metastasis in patients with T1mi breast cancer. Thus, the patients with T1mi breast disease are indicated to a careful evaluation of axillary lymph node metastasis, if they have the earlier-mentioned unfavorable factors.

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Section: Discussionsupporting

confidence: 50%

“…This system refers only to the largest invasive component and it ignores the size of the DCIS and the number of invasive foci. This diversity in the histopathologic definition may explain the 0 -22% range of the reported rates of axillary lymph node metastasis (ALNM) in patients with microinvasive breast carcinoma (7,8).…”

Section: Introductionmentioning

confidence: 99%

The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

Lee

Suh

Shim

et al. 2011

Japanese Journal of Clinical Oncology

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“…It is emphasized that the probability of nodal deposits in T1a and T1b breast cancers is dependent not only on tumor size, but also on grade and patient age, and may range from 3% to 37% (20). In another study, 10% of patients with T1a and 15% with T1b cancers harbored nodal deposits in the axilla.…”

Section: Extent Of Surgerymentioning

confidence: 97%

Axillary Surgery in Breast Cancer Management: Background, Incidence and Extent of Nodal Spread, Extent of Surgery and Accurate Axillary Staging, Surgical Procedures

Blichert-Toft¹

2000

Acta Oncologica

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The prime objectives of axillary surgery in the management of breast cancer are 1) accurate staging, 2) treatment to cure and 3) quantitative information of metastatic lymph nodes for prognostic purposes and allocation to adjuvant protocols. It is generally agreed that axillary node status in potentially curable breast cancer is considered the single best predictor of outcome and the main determinant of allocation to adjuvant therapy. No physical examination, no imaging techniques, and no molecular biologic markers can today replace axillary surgery for staging purposes. The objectives of axillary surgery are best obtained by carrying out a complete axillary clearance. Nonetheless, less radical surgery is generally performed by carrying out a sampling procedure with a yield of about 4 nodes or a partial axillary dissection level I-II with at least 10 nodes recovered. Understaging the axilla is detrimental to outcome and, furthermore, locoregional tumor control is important for survival. Axillary surgery should therefore be conducted in accordance with high professional standards.

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“…1 In an attempt to simplify breast cancer management and avoid the morbidity of axillary dissection, some have advocated selective axillary dissection or avoiding dissection altogether in women with small breast cancers. [2][3][4][5][6][7] They argue that no trial has proven a survival advantage for axillary dissection, that pathological characteristics of the primary tumor can provide adequate information for treatment decision making and prognostication, and that the incidence of nodal metastases is so small that any benefit accrued to the patients with node-positive tumors is more than outweighed by the morbidity suffered by the whole group. [2][3][4][5]7 Support for this view comes from several series of studies that show a very low incidence of nodal metastases in tumors 5 mm in diameter or smaller (T1a).…”

mentioning

confidence: 99%

Six-Year Follow-Up of Patients With Microinvasive, T1a, and T1b Breast Carcinoma

et al. 1999

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Indications for axillary dissection in T1 breast cancer

Cited by 26 publications

References 12 publications

The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

The Incidence and Predictor of Lymph Node Metastasis for Patients with T1mi Breast Cancer Who Underwent Axillary Dissection and Breast Irradiation: An Institutional Analysis

Axillary Surgery in Breast Cancer Management: Background, Incidence and Extent of Nodal Spread, Extent of Surgery and Accurate Axillary Staging, Surgical Procedures

Six-Year Follow-Up of Patients With Microinvasive, T1a, and T1b Breast Carcinoma

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