CLINICAL BEHAVIOR OF UNTREATED AXILLARY NODES AFTER LOCAL TREATMENT FOR PRIMARY BREAST-CANCER

Background: The purpose of this study was to examine the rate of axill ary failure in patients with primary breast cancer treated without axi llary dissection or radiation and to determine what factors may be ass ociated with axillary failure. Methods: We studied 112 patients with i nvasive breast cancer treated for primary disease with breast-conservi ng surgery without axillary dissection or radiation to the breast or a xilla, accrued between 1977 and 1986, Data for these patients were pro spectively gathered for a research database and reviewed retrospective ly to determine axillary failure. The effects of age, tumor size, estr ogen receptor (ER) status, progesterone receptor (PgR) status, histolo gic grade, nuclear grade, and tumor emboli on time to axillary failure were examined. Results: The median follow-up was 9.6 years. There wer e 26 axillary recurrences, resulting in a 10-year actuarial nodal cont rol rate of 72%. Patients with nodal failure proceeded to axillary dis section with minimal morbidity. In both univariate and multivariate an alyses, only tumor size was significantly associated with axillary fai lure (p = 0.04 and p = 0.06, respectively). Conclusions: This study de monstrates a significant effect of tumor size on axillary failure and a reasonable rate of local control in small tumors. Further research s hould examine the utility of axillary dissection in women with small b reast cancers.