Does axillary dissection affect prognosis in T1 breast tumors?

Background: The treatment of patients with breast cancer has undergone many revisions over recent decades. The current trend is toward limited resecti ons and breast conservation. Some authors advocate the abandonment of axill ary lymph node dissection (ALND) for small tumors. While it is accepted tha t ALND has no therapeutic effect in breast cancer patients, its prognostic significance for small tumors is debated. Eligibility criteria for surgical treatment without axillary dissection are evolving. Methods: Considering that problem, we retrospectively reviewed the charts o f 100 patients with T1 invasive carcinoma of the breast treated at Hippokra tion Hospital of Athens between 1986 and 1987. Patients were divided into t wo groups: those that underwent ALND (n=76) and those that did not (n=24). The following data were recorded: age, tumor size, grade, hormone receptor status and postoperative treatment. The ten-year overall and disease-free s urvival were analysed. A multivariate analysis was used to identify prognos tic variables. Results: There was no statistically significant difference in the ten-year overall and disease-free survival between the two groups. The univariate an alysis showed that tumor size predicts both recurrence and survival. In the multivariate analysis tumor size was found to be an independent prognostic factor for overall survival. Conclusions: ALND did not influence the ten-year survival or the recurrence rate. Tumor size was the only statistically significant and independent pr ognostic factor for T1 breast cancer patients.