Detection, treatment and outcome of axillary recurrence after axillary clearance for invasive breast cancer

Background: The aim was to gain insight into the diagnosis, treatment and p rognosis of axillary recurrence after axillary clearance for invasive breas t cancer in a large patient series. Methods: Between 1984 and 1994, 4669 patients with invasive breast cancer u nderwent axillary clearance in eight community hospitals in the south-easte rn part of the Netherlands. Using follow-up data in a population-based canc er registry, 59 patients with axillary recurrence were identified. Results: The median interval between treatment of the primary tumour and th e diagnosis of axillary recurrence was 2.6 (range 0.3-10.7) years. In 51 pa tients (86 per cent), axillary recurrence was found by palpation during rou tine follow-up. Surgery was part of the treatment of recurrence for 41 of 5 9 patients. Regional control (complete eradication of axillary recurrence) was achieved in 34 patients (58 per cent). The 5-year actuarial survival ra te was 39 (95 per cent confidence interval 25-53) per cent. Patients with n egative axillary lymph nodes at the time of diagnosis of the primary tumour and complete eradication of axillary recurrence had the best prognosis. Conclusion: Patients with axillary recurrence had a poor prognosis, except when complete eradication was achieved and axillary lymph nodes were negati ve at the time of diagnosis of the primary tumour.