Skip to main content

How Much of the Axilla Should Be Dissected?

  • Chapter
Non-Disseminated Breast Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 48 Accesses

Abstract

The spread of breast cancer from the primary tumor in the breast to regional lymph nodes is an indication of the capacity of cancer cells to implant and grow, as well as a comment on the host-tumor relationship; it also is a potential source of morbidity. Despite the clear impact of axillary nodal metastases on prognosis, there is no evidence that axillary treatments significantly affect survival. Al- though the possibility of a small therapeutic benefit cannot be excluded by the studies to date, the primary benefits of removing axillary lymph nodes are to gather information on Staging and to prevent complications arising from uncontrolled tumor growth in the axilla. Information on axillary Staging is vital when the axillary node status is a major determinant of the use of systemic therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Adami HO, Graffman S, Johansson H, Rimsan A (1978) Survival and recurrence five years after selective treatment for breast cancer. Br J Cancer 38: 624–630

    Article  PubMed  CAS  Google Scholar 

  • Almarick R, Santamaria F, Robert F et al (1982) Radiation therapy with or without primary limited surgery for operable breast cancer: a 20-year experience at the Marseilles Cancer Institute. Cancer 49: 30–34

    Article  Google Scholar 

  • Cancer Research Campaign Work Party (1980) Cancer Research Campaign ( King’s/Cambridge) trial for early breast cancer. Lancet ii: 55–60

    Google Scholar 

  • Carter CL, Allen C, Henson DE (1989) Relation of tumor size, lymph node status, and survival in 24740 breast cancer cases. Cancer 63: 181–187

    Article  PubMed  CAS  Google Scholar 

  • Clarke D, Martinez A, Cox R et al (1982) Breast edema following Staging axillary node dissection in patients with breast carcinoma by radical radiotherapy. Cancer 49: 2295

    Article  PubMed  CAS  Google Scholar 

  • Clarke DH, Le MG, Sarrazin D et al (1985) Analysis of local-regional relapses in patients with early breast cancers treated by excision and radiotherapy: experience of the Institute Gustave-Roussy. Int J Radiat Oncol Biol Phys 11: 137–145

    Article  PubMed  CAS  Google Scholar 

  • Cody HS, Egeli RA, Urban JA (1984) Rotter’s node metastases: therapeutic and prognostic considerations in early breast carcinoma. Ann Surg 199: 266–270

    Article  PubMed  Google Scholar 

  • Danforth DN, Findlay PA, McDonald HD et al (1986) Complete axillary lymph node dissection for Stage I–II carcinoma of the breast. J Clin Oncol 4: 655–662

    PubMed  Google Scholar 

  • Davies GC, Millis RR, Hayward JL (1980) Assessment of axillary lymph node status. Ann Surg 192: 148–151

    Article  PubMed  CAS  Google Scholar 

  • Dewar JA, Sarrazin D, Benhamou E et al (1987) Management of the axilla in conservatively treated breast cancer: 592 patients treated at the Institute Gustave-Roussy. Int J Radiat Oncol Biol Phys 13: 475–481

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  • Fisher ER, Swamidoss S, Lee CH et al (1978) Detection and significance of occult axillary node metastases in patients with invasive breast cancer. Cancer 42: 2025–2031

    Article  PubMed  CAS  Google Scholar 

  • Forrest APM, Roberts MM, Cant E, Shivas AA (1976) Simple mastectomy and pectoral node biopsy. Br J Surg 63: 569–575

    Article  PubMed  CAS  Google Scholar 

  • Fowble B, Gray R, Gilchrist K et al (1988) Identification of a subgroup of patients with breast cancer and histologically positive axillary nodes receiving adjuvant chemotherapy who may benefit from postoperative radiotherapy. J Clin Oncol 6: 1107–1117

    PubMed  CAS  Google Scholar 

  • Graversen HP, Blichert-Toff M, Andersen JA et al (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 

  • Griem KL, Henderson IC, Gelman R et al (1987) The 5-year results of a randomized trial of adjuvant radiation therapy after chemotherapy in breast cancer patients treated with mastectomy. J Clin Oncol 5: 1546–1555

    PubMed  CAS  Google Scholar 

  • Haffty BG, Fischer D, Rose M et al (1991) Prognostic factors for local recurrence in the conservatively treated breast cancer patient: a cautious interpretation of the data. J Clin Oncol 9: 997–1003

    PubMed  CAS  Google Scholar 

  • Hayward J (1984) The principles of breast cancer surgery. Breast Cancer Res Treat 4: 61–68

    Article  PubMed  CAS  Google Scholar 

  • Hayward J, Caleffi M (1987) The significance of local control in the primary treatment of breast cancer. Arch Surg 122: 1244–1247

    Article  PubMed  CAS  Google Scholar 

  • Kinne DW, Petrek JA, Osborne MP et al (1989) Breast carcinoma in situ. Arch Surg 124: 33–36

    Article  PubMed  CAS  Google Scholar 

  • Kissin MW, Price AB, Thompson EM et al (1982) The inadequacy of axillary sampling in breast cancer. Lancet 1: 1210–1211

    Article  PubMed  CAS  Google Scholar 

  • Kissin MW, Querci della Rovere G, Easton D, Westburg G (1986) Lymphoedema and breast cancer. Br J Surg 73: 580–584

    Article  PubMed  CAS  Google Scholar 

  • Kitchen PRB, McLennan R, Mursell A (1980) Node-positive breast cancer: a comparison of clinical and pathological findings and assessment of axillary clearance. Aust NIJ Surg 50: 580–583

    Article  CAS  Google Scholar 

  • Lagios MD, Westdahl PR, Margolin FR, Rose MR (1982) Duct carcinoma in situ: relationship of extent of noninvasive disease to the frequency of occult invasion, multicentricity, lymph node metastases, and short-term treatment failures. Cancer 50: 1209–1314

    Article  Google Scholar 

  • Larson D, Weinstein M, Goldberg I et al (1988) Edema of the arm as a function of the extent of axillary surgery in patients with Stage I–II carcinoma of the breast treated with primary radiotherapy. Int J Radiat Oncol Biol 12: 1575–1582

    Article  Google Scholar 

  • McCready DR, Hortobagyi GN, Kau SW et al (1989) The prognostic significance of lymph node metastases after preoperative chemotherapy for locally advanced breast cancer. Arch Surg 124: 21–25

    Article  PubMed  CAS  Google Scholar 

  • Osborne MP, Orniston N, Harmer CL et al (1984) Breast conservation in the treatment of early breast cancer: a 20-year follow-up. Cancer 53: 349–355

    Article  PubMed  CAS  Google Scholar 

  • Osteen RT, Smith B (1990) Results of conservative surgery and radiation therapy for breast cancer. Surg Clin N Am 70: 1005–1021

    PubMed  CAS  Google Scholar 

  • Pari FF, Schmidt BP, Dupont WD, Wagner RK (1984) Prognostic significance of estrogen receptor status in breast cancer in relation to tumor stage, axillary node metastases and histopathologic grading. Cancer 54: 2237–2242

    Article  Google Scholar 

  • Recht A, Pierce SM, Abner A et al (1991) Regional nodal failure after conservative surgery and radiotherapy for early-stage breast carcinomas. J Clin Oncol 9: 988–996

    PubMed  CAS  Google Scholar 

  • Rose CM, Botnick LE, Weinstein M et al (1983) Axillary sampling in the definitive treatment of breast cancer by radiation therapy and lumpectomy. Radiat Oncol Biol Phys 9: 339–344

    CAS  Google Scholar 

  • Rose MA, Henderson IC, Gelman R et al (1989) Pre- menopausal breast cancer patients treated with conservative surgery, radiotherapy, and adjuvant chemotherapy have a low risk of local failure. Int J Radiat Oncol Biol Phys 17: 711–717

    Article  PubMed  CAS  Google Scholar 

  • Rose MA, Olivotto I, Koufman C et al (1989) Conservative surgery and radiation therapy for early breast cancer: long-term cosmetic results. Arch Surg 124: 153–157

    Article  PubMed  CAS  Google Scholar 

  • Rosen PP (1980) Axillary lymph node metastases in patients with occult noninvasive breast carcinoma. Cancer 46: 1298–1306

    Article  PubMed  CAS  Google Scholar 

  • Rosen PP, Saigo PE, Braun DW et al (1981) Axillary micro- and macrometastases in breast cancer: prognostic significance of tumor size. Ann Surg 194: 585–591.

    Article  PubMed  CAS  Google Scholar 

  • Rosen PP, Lesser ML, Kinne DW, Beattie EJ (1983) Dis- continuous or “skip” metastases in breast carcinomas: analysis of 1228 axillary dissections. Ann Surg 197: 276–287

    Article  PubMed  CAS  Google Scholar 

  • Rosner D, Lane WW (1991) Should all patients with node- negative breast cancer receive adjuvant therapy? Identifying additional subsets of low-risk patients who are highly curable by surgery alone. Cancer 68: 1482–1494

    Article  PubMed  CAS  Google Scholar 

  • Sarrazin D, Le M, Arriagada R et al (1989) Ten year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer. Radiother Oncol 14: 177

    Article  PubMed  CAS  Google Scholar 

  • Senofsky GM, Moffat FL, Davis K et al (1991) Total axillary lymphadenectomy in the management of breast cancer. Arch Surg 126: 1336–1342

    Article  PubMed  CAS  Google Scholar 

  • Silverstein MJ, Rosser RJ, Gierson ED (1987) Axillary lymph node dissection for intraductal breast carcinoma — is it indicated? Cancer 59: 1819–1824

    Article  PubMed  CAS  Google Scholar 

  • Silverstein MJ, Waisman JR, Gamagami P et al (1990) Intraductal carcinoma of the breast (208 cases): clinical factors influencing treatment choice. Cancer 66: 102–108

    Article  PubMed  CAS  Google Scholar 

  • Temple WJ, Jenkins M, Alexander F et al (1989) Natural history of in situ breast cancer in a defined population. Ann Surg 210: 653–657

    Article  PubMed  CAS  Google Scholar 

  • Veronesi U, Saccozzi R, Del Vecchio M et al (1981) Comparing radical mastectomy with quadrantectomy, axillary dissection and radiotherapy in patients with small cancers of the breast. N Engl J Med 305: 6–11

    Article  PubMed  CAS  Google Scholar 

  • Winchester DP (1991) Adjuvant therapy for node-negative breast cancer: the use of prognostic factors in selecting patients. Cancer 67: 1741–1743

    PubMed  CAS  Google Scholar 

  • Wolmark N, Fisher B (1982) Surgery in the primary treatment of breast cancer. Brest Cancer Res Treat 1: 339–348

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1993 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Osteen, R.T. (1993). How Much of the Axilla Should Be Dissected?. In: Fletcher, G.H., Levitt, S.H. (eds) Non-Disseminated Breast Cancer. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84593-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-84593-2_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-84595-6

  • Online ISBN: 978-3-642-84593-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics