PMID: 8957459Dec 1, 1996Paper

Therapeutic options and results for the management of minimally invasive carcinoma of the breast: influence of axillary dissection for treatment of T1a and T1b lesions

Journal of the American College of Surgeons
R E WhiteK I Bland

Abstract

Axillary dissection has maintained a role of primacy for the surgical therapy of invasive carcinoma of the breast for many years. More recently, early (T1) minimally invasive carcinoma of the breast has been diagnosed with increasing frequency, and the necessity of axillary dissection for sampling purposes in these small tumors has been questioned, based primarily on the finding of low rates of axillary metastases. The Rhode Island State Tumor Registry records of 1,126 patients with T1a or T1b tumors were examined to assess the effect of axillary dissection on patient outcome. These data span 9 years (1985 to 1992) with a median follow-up duration of 64 months. Five-year overall, disease-free, and breast cancer-specific (determinate) survival were determined according to treatment modality. Axillary node positivity was calculated for patients with minimally invasive carcinoma of the breast who underwent axillary dissection. Multivariate statistical methods were used to provide adjustment for known confounding prognostic variables. Omission of axillary dissection occurred in 157 cases and correlated with reductions in overall, disease-free, and breast cancer-specific survival (p < .001 in all cases). Nodal status significantly i...Continue Reading

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