Axillary Lymph Node Dissection Advised for Most Small Invasive Cancers

Deciding against axillary dissection of lymph nodes in patients with small invasive breast cancer may be an ill-advised strategy, according to researchers in Strasbourg, France.

Axillary lymph node involvement is the most accurate predictor for recurrence risk and survival in patients with invasive breast cancer, and is considered an essential element in therapeutic decisions, according to the researchers.

However, axillary dissection is not automatically performed in the case of small invasive breast cancers. Researchers developed a study to define a predictive model of axillary lymph node involvement by using clinical and histologic variables available before surgery.

Researchers analyzed 795 cases of small invasive breast cancer tumors that were treated between 1980 and 1997 and whose treatment included an axillary dissection with at least 10 lymph nodes removed.

Depending upon variables such as clinical tumor size, location, and histological subtype and grade, the probability of axillary nodal involvement in these patients was between 6 and 45 percent, with an overall rate of 25.7 percent, according to the study published in the journal Cancer.

"We do not recommend to omit axillary dissection in women whose estimated risks are higher than 25 percent," concluded the researchers. "Women with a risk of axillary lymph node involvement lower than 25 percent could benefit from the sentinel lymph node procedure with, likewise, a limited risk of false-negative."

Other Sources: Cancer