INTRAOPERATIVE ASSESSMENT OF AXILLARY LYMPH-NODE METASTASES IN OPERABLE BREAST-CANCER

The diagnostic value of intraoperative histologic examination of froze n sections of axillary lymph nodes was investigated in 243 patients wi th operable breast cancer. One to six hard or enlarged axillary nodes were sampled from the axillary pad which was derived from a partial ax illary dissection (including level 1 and 2 nodes). Half of these nodes were histologically examined using frozen sections during surgery. Af ter a total axillary dissection, both the axillary nodes in the partia l axillary dissection and the nodes dissected at level 3 were histolog ically examined on permanent section. A mean of four nodes were sample d (range: 1 to 6). Axillary dissection yielded a mean of 22 nodes (ran ge: 6 to 60). Axillary sampling detected the presence of metastases in 65 of 84 (77%) patients with positive axillary lymph nodes, In the pa tients in whom the axillary involvement was not identified by axillary sampling, however, the extent of axillary involvement was limited to levels 1 and 2, Therefore, a partial axillary dissection may be justif ied for patients in whom axillary involvement is not found on frozen s ection of nodes from axillary sampling, whereas a total axillary disse ction should be performed for patients in whom axillary involvement is found by these procedures.