STAGING THE AXILLA IN BREAST-CANCER - AN AUDIT OF LYMPH-NODE RETRIEVAL IN ONE UK REGIONAL CENTER

Aims: Many surgeons undertake a level 1 axillary dissection in patient s with invasive breast cancer. This dissection yields a variable numbe r of lymph nodes for histological study. In this study, we report the consequences of this policy for staging of the axilla. Methods: Betwee n January 1995 and December 1995, 236 patients with a diagnosis of inv asive breast cancer underwent axillary surgery. Results: A median of e ight nodes was identified (range 0-30). In only 11 patients less than four nodes were identified. An increase in the number of nodes harvest ed was associated with a higher proportion of node-positive patients a nd a higher number of metastatic nodes identified. Conclusions: We con cluded that a standardized approach to axillary dissection consistentl y yields an adequate sample of lymph nodes for staging purposes. Most importantly, larger node samples yield higher detection rates for meta stasis. This has a significant bearing on patient selection for adjuva nt chemotherapy when compared with more limited sampling practices, in cluding solitary sentinel node detection and biopsy.