PROGNOSIS OF PATIENTS WITH BREAST CANCERS UP TO 1 CM IN DIAMETER

The prognosis of patients with tumours measuring up to 1 cm diameter w as examined. 336 patients treated at Guy's Hospital between 1975 and 1 994 were reviewed. Of these, 103 (31%) were lymph node-positive, with approximately one third of these having one node involved, one third t wo to three nodes and one third four nodes or more. A similar proporti on of those with palpable and impalpable tumours had axillary node inv olvement. Patients with axillary node involvement had a significantly worse prognosis and those node-positive patients with impalpable cance rs had a significantly worse outcome compared with node-positive palpa ble cases. When patients were subdivided on a basis of nodal status an d age (less than or equal to 50 or > 50), node-positive women aged > 5 0 fared significantly better than younger women. These data suggest th e need to know accurately the axillary nodal status of patients with s mall breast cancers, whether symptomatic or detected by screening. Thi s knowledge will allow women with curable cancers to be identified tog ether with those who have a worse prognosis and who will be likely to benefit fi om systemic adjuvant therapy.