AXILLARY NODAL METASTASES FROM AN OCCULT PRIMARY CONSISTENT WITH BREAST-CARCINOMA

The records of 15 women presenting with axillary nodal metastases from an occult primary consistent with breast carcinoma were reviewed. Nin e patients underwent complete axillary clearance and in six the clinic al mass only was excised. Radiotherapy to the axilla was given to eigh t patients. One woman underwent mastectomy at the time of axillary sur gery but no tumour was found in the excised breast; in the remaining 1 4 patients the breast was left untreated. One premenopausal woman rece ived adjuvant systemic chemotherapy and one postmenopausal patient was given tamoxifen. Three patients died from recurrent disease at 16, 50 and 56 months after treatment of the axillary mass; one is alive at 4 2 months with systemic recurrence. In two of these patients the tumour in the breast became apparent before other metastases. Eleven patient s survived for a median of 92 (range 18-144) months without evidence o f disease. The prognosis of this patient group is better than that gen erally reported for stage II breast carcinoma.