BREAST-CANCER IN WOMEN OVER 75 YEARS - IS AXILLARY DISSECTION ALWAYS NECESSARY

Objective: To study how the information gained from axillary dissectio n in women (75 years old or more) with breast cancer influenced postop erative adjuvant treatment. Design: Retrospective review of casenotes. Setting: University departments of surgery and oncology, Sweden. Subj ects: 166 women (aged 75 years or more) operated on for primary breast cancer between 1980-1989. Main outcome measures: Type of operation an d postoperative therapy given. Results: In 138/166 (83%) women axillar y dissection was done, but in only 21/59 (36%) of these patients did i nformation gained from the procedure influence the postoperative treat ment according to the treatment guidelines for breast cancer. None of the 28 patients who did not undergo axillary dissection were subjected to further operations or radiotherapy for axillary nodal recurrence a fter a mean follow up of 47 months. Conclusions: Axillary dissection s hould be reserved for local control of disease and for those patients who preoperatively agree to undergo postoperative irradiation or chemo therapy if metastases are found.