Ma. Kutiyanawala et al., STAGING THE AXILLA IN BREAST-CANCER - AN AUDIT OF LYMPH-NODE RETRIEVAL IN ONE UK REGIONAL CENTER, European journal of surgical oncology, 24(4), 1998, pp. 280-282
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.