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The Axilla: To Clear or Not to Clear? That Is the Question!

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Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 152))

Abstract

Management of the axilla in patients with operable breast cancer is still hedged in by firm convictions. The most appropriate way of handling the axilla is a constant matter of great controversy. Views differ widely and opinions are strongly held (Fentiman et al. 1996). When the smoke had faded away, two main purposes remain, viz. (1) staging the axilla and (2) treating the axilla.

For few diseases does there exist a greater diversity of opinion regarding proper management than for mammary carcinoma. (William L. Donegan, 1967)

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References

  • Axelsson CK, Mouridsen T, Zedeler K (1992) Axillary dissection of level I and II lymph nodes is important in breast cancer classification. Eur J Cancer 28 A:1415–1418

    Article  Google Scholar 

  • Blichert-Toft M, Smola G, Cataliotti L, O’Higgins N (1997) Principles and guidelines for surgeons — management of symptomatic breast cancer. Eur J Surg Oncol 23:101–109

    Article  PubMed  CAS  Google Scholar 

  • British Association of Surgical Oncology (1995) Guidelines for surgeons in the management of symptomatic breast disease in the United Kingdom. Eur J Surg Oncol 21 Suppl A:1–13

    Google Scholar 

  • Cabanes PA, Salmon RJ, Vilcoq JR, Durand JC, Fourquet A et al (1992) Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer. Lancet 339:1245–1248

    Article  PubMed  CAS  Google Scholar 

  • Cady B, Stone MD, Schuler JG, Thakur R, Wanner MA et al (1996) The new era in breast cancer: invasion, size, and nodal involvement dramatically decreasing as a result of mammographic screening. Arch Surg 131:301–308

    Article  PubMed  CAS  Google Scholar 

  • Cascinelli N, Greco M, Bufalino R, Clemente C, Galluzo D et al (1987) Prognosis of breast cancer with axillary node metastasis after surgical treatment only. Eur J Cancer Clin Oncol 23:795–799

    Article  PubMed  CAS  Google Scholar 

  • DBCG (1997) Danish Breast Cancer Cooperative Group: Data collection, Secretariat. Righs-hospitalet, Copenhagen

    Google Scholar 

  • Dombernowski P, Brincker H, Hansen M, Mouridsen HT, Overgaard M et al (1988) Adjuvant therapy of premenopausal and menopausal high-risk breast cancer patients. Acta Oncol 27:691–697

    Article  Google Scholar 

  • Dowlatshahi K, Snider HC, Kim R (1995) Axillary node status in nonpalpable breast cancer. Ann Surg Oncol 2:424–428

    Article  PubMed  CAS  Google Scholar 

  • Fentiman IS, Epstein R, Barr L (1996) Is routine axillary nodal dissection necessary in the treatment of breast cancer? Eur J Cancer 32A:1460–1461

    Article  PubMed  CAS  Google Scholar 

  • Fisher B, Wolmark N, Bauer M, Redmond C, Gebhardt M (1981) The accuracy of clinical nodal staging and of limited axillary dissection as a determinant of histologic nodal status in carcinoma of the breast. Surg Gynecol Obstet 152:765–772

    PubMed  CAS  Google Scholar 

  • Fisher B, Redmond C, Fisher ER, Bauer M, Wolmark N et al (1985) Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation. N Engl J Med 312:674–681

    Article  PubMed  CAS  Google Scholar 

  • Gardner B, Feldman J (1993) Are positive axillary nodes in breast cancer markers for incurable disease? Ann Surg 218:270–278

    Article  PubMed  CAS  Google Scholar 

  • Graversen HP, Blichert-Toft M, Andersen JA, Zedeler K (1988) Breast cancer: risk of axillary recurrence in node-negative patients following partial dissection of the axilla. Eur J Surg Oncol 14:407–412

    PubMed  CAS  Google Scholar 

  • Graversen HP, Zedeler K, Andersen JA, Axelsson CK, Blichert-Toft M (1992) Axillary dissection at primary surgical treatment for cancer of the breast. The risk of false-negative axillary status. Ugeskr Laeger 154:3392–3395

    PubMed  CAS  Google Scholar 

  • Greenall MJ (1995) Why I favour axillary node sampling in the management of breast cancer. Eur J Surg Oncol 21:2–7

    PubMed  CAS  Google Scholar 

  • Harris JR, Osteen RT (1985) Patients with early breast cancer benefit from effective axillary treatment. Breast Cancer Res Treat 5:17–21

    Article  PubMed  CAS  Google Scholar 

  • Hellman S (1994) Natural history of small breast cancers. J Clin Oncol 12:2229–2234

    PubMed  CAS  Google Scholar 

  • Mattheiem W, Bourgeois P, Delcorde A, Stegen M, Frühling J (1989) Axillary dissection in breast cancer revisited. Eur J Surg Oncol 15:490–495

    PubMed  CAS  Google Scholar 

  • Morrow M (1996) Role of axillary dissection in breast cancer management. Ann Surg Oncol 3:233–234

    Article  PubMed  CAS  Google Scholar 

  • Mouridsen HT, Rose C, Overgaard M, Dombernowski P, Panduro J et al (1988) Adjuvant treatment of postmenopausal patients with high-risk primary breast cancer. Acta Oncol 27:699–705

    Article  PubMed  CAS  Google Scholar 

  • O’Higgins N (1994) How I minimize morbidity in axillary dissection. Eur J Surg Oncol 20:80–81

    PubMed  Google Scholar 

  • Overgaard M, Hansen PS, Overgaard J, Rose C, Andersson M et al (1997) Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med 337:949–955

    Article  PubMed  CAS  Google Scholar 

  • Ragaz J, Jackson SM, Le N, Plenderleith IH, Spinelli JJ et al (1997) Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med 337:956–962

    Article  PubMed  CAS  Google Scholar 

  • Rainsbury RM (1997) New advances in the surgical treatment of breast cancer. Breast 6:349–353

    Article  Google Scholar 

  • Riddell V (1948) Hunterian lecture: carcinoma of the breast. Royal cCollege of Surgeons of England, London

    Google Scholar 

  • Sacks NPM, Barr LC, Allan SM, Baum M (1992) The role of axillary dissection in operable breast cancer. Breast 1:41–49

    Article  Google Scholar 

  • Steele RJC, Forrest APM, Gibson T, Stewart HJ, Chetty U (1985) The efficacy of lower axillary sampling in obtaining lymph node status in breast cancer: a controlled randomized trial. Br J Surg 72:368–369

    Article  PubMed  CAS  Google Scholar 

  • Veronesi U, Luini A, Galimberti V, Marchini S, Sacchini V et al (1990) Extent of metastatic axillary involvement in 1446 cases of breast cancer. Eur J Surg Oncol 16:127–133

    PubMed  CAS  Google Scholar 

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© 1998 Springer-Verlag Berlin · Heidelberg

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Blichert-Toft, M. (1998). The Axilla: To Clear or Not to Clear? That Is the Question!. In: Senn, HJ., Gelber, R.D., Goldhirsch, A., Thürlimann, B. (eds) Adjuvant Therapy of Primary Breast Cancer VI. Recent Results in Cancer Research, vol 152. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-45769-2_14

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  • DOI: https://doi.org/10.1007/978-3-642-45769-2_14

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-45771-5

  • Online ISBN: 978-3-642-45769-2

  • eBook Packages: Springer Book Archive

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