NODE-POSITIVE BREAST-CANCER - AXILLARY MICROMETASTASES, THEIR INCIDENCE AND SOME IMPLICATIONS

In node-positive breast carcinoma, the presence of tumour cells in the efferent vessels (EV) of the axillary nodes (positive EV status) was shown to be of poor prognosis in 1979. Later the presence of nodal mic rometastases was also related to survival. This report describes a new subgroup in this system that is of potential therapeutic interest. It consisted of the 40% of the EV-positive cases with micrometastases (< 0.2 cm(2)) in their nodes, in addition to nodes with macrometastases. In them the difference in prognosis associated with EV status no longe r held. Their prognosis did not differ markedly from that in the EV-ne gative patients. In the absence of such 'additional' micrometastases, the prognostic difference was still highly significant. There was also some indication that the presence of micrometastases consisting of em bolic tumour growth alone may be associated with early death in EV-neg ative cases, in keeping with the prognosis in cases with lone micromet astases.