CARCINOMA IN-SITU OF THE BREAST - IS AXIL LARY LYMPHADENECTOMY NECESSARY

Between 1963 and 1993, 3720 women were treated both at the Universitat s-Frauenklinik Berlin-Charlottenburg and at the I. Frauenklinik der Un iversitat 187 of these (5%) exhibited stage p Tis, 102 (54.5%) of whom had an axillary lymphadenectomy. One patient had a micrometastasis (p N1a). During the observation period of up 24 years, 11 patients (5.9%) developed local recurrence. In none of the patients a regional or gen eralised recurrence could be observed within this period. On the basis of our own results and those from the literature, we conclude that, u nder the aspect of a risk-adapted tumour surgery, axillary lymphadenec tomy is no longer necessary under certain conditions: an invasive carc inoma should be excluded with high certainly in the tumourectomy speci men as well as in the remaining breast. Therefore, a hislological work -up in serial sections must be provided to exclude multifocality (mult icentricity) and a tumour diameter larger than 25 mm.