Impact of axillary dissection on staging and regional control in breast tumors <= 10 mm - The DBCG experience

Data from 4771 patients with tumor diameters less than or equal to 10 mm we re analyzed. Results of surgery and pathoanatomical examinations indicated that nodal status was related to diameter, but not to number of nodes remov ed. More axillary metastases were found in group T1b tumors than in T1a. In 8% of tumors, at least 4 positive nodes were identified. Mean number of po sitive nodes was related to number of nodes removed, and when 10 or more no des were removed a significantly lower axillary recurrence rate and better recurrence-fret survival were demonstrated, confirming that axillary surger y has two goals: staging and regional disease control. Age, receptor status , grade and histological type, but not tumor location, were related to prog nosis. In accordance with the classical prognostic factors, it was not poss ible to define a patient group where axillary surgery was superfluous. We c onclude that proper staging and regional control renders a full axillary le vel I-II dissection necessary.