Axillary Node Dissection in Breast Cancer
Axillary node dissection has been part of standard therapy for early breast cancer for more than a century. Since Fisher proposed that most breast cancers have spread before their detection, there has been controversy surrounding whether axillary node dissection is necessary in the treatment of early breast cancer. A trend toward less radical surgery and the possibility that axillary node involvement represents only a marker for distant disease has led many to believe that sampling the axilla is adequate and that full axillary dissection need not be performed. Reliable identification of the first node draining the tumor (the sentinel node), better pathologic staging of the primary tumor, more aggressive use of chemotherapy, and detection of smaller and smaller lesions have all contributed to the controversy.
KeywordsBreast Cancer Sentinel Node Sentinel Node Biopsy Axillary Node Axillary Node Dissection
Unable to display preview. Download preview PDF.
- 1.le Dran F (1757) Memoire avec un precis de plusieurs observations sur le cancer. Mem. Acad. R. Chir. Paris 3, 1–56.Google Scholar
- 2.Petit JL (1837) Oeuvres Completes, section VII. R. Chapoulard, Limoges, pp. 438–445.Google Scholar
- 4.Wagner FB, Martin RG, Bland KI (1998) History of the therapy of breast disease. In: Bland KI, Copeland EM (eds.) The Breast: Comprehensive Management of Benign and Malignant Diseases, 2nd ed. WB Saunders, Philadelphia.Google Scholar
- 5.Halstead WS (1894–1895) The results of operations for cure of cancer of the breast performed at the Johns Hopkins Hospital from June 1889 to January 1894. Johns Hopkins Hosp. Rep. 4, 297–350.Google Scholar
- 29.Iyer R, Hanlon AL, Fowble B, et al. Accuracy of the extent of axillary nodal positivity related to primary tumor size, number of involved, and number of nodes examined. Int. J. Radiat. Oncol. Biol. Phys. 47, 1177–1183.Google Scholar
- 40.Lythoge J, Palmer M (1982) Manchester regional breast study-5 and 10 year results. Br. J. Surg. 69, 639–636.Google Scholar
- 41.Crile G (1964) Results of simplified treatment of breast cancer. Surg. Gynecol. Obstet. 517–523.Google Scholar