Axillary lymphadenectomy—just how radical should it be?

• Published in: Surgical oncology 1996-02, Vol.5 (1), p.37-41
• Main Authors: Rageth, J.Ch, Wyss, P., Unger, C., Haller, U.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Axilla; axillary clearance; axillary lymphadenectomy; axillary recurrence; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma - pathology; Carcinoma - secondary; Carcinoma - surgery; Disease-Free Survival; Female; Follow-Up Studies; Humans; Lymph Node Excision - methods; Lymph Nodes - pathology; Lymphatic Metastasis; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Recurrence, Local - prevention & control; Retrospective Studies
• ISSN: 0960-7404; 1879-3320
• DOI: 10.1016/S0960-7404(96)80020-X

To determine whether local axillary recurrences correlate with the number of lymph nodes extirpated, 779 cases of breast cancer were analysed in retrospect. Results: The number of lymph nodes extirpated varied between 1 and 42 per axilla. The axillary recurrence rate of 5.5% showed a minimal correlation between the frequency of these recurrences and the number of lymph nodes removed. There is an equally insignificant correlation between the percentage of positive histological findings and the number of lymph nodes extirpated: The trend analysis shows that with fewer than five lymph nodes extirpated, 40% of positive histological findings can be expected, whereas with over 20 lymph nodes extirpated the percentage is 45%. Conclusion: The number of lymph nodes extirpated is an unsuitable indicator as to how radical axillary clearance is. Surgeons should rely on anatomical boundaries rather than focusing on the number of lymph nodes removed.