title: [Axillary lymph node dissection in clinically node-positive breast cancer].
abstract: Many Japanese surgeons think that clinically node-positive breast cancer is already a systemic disease. However, about 60% of surgeons believe that the survival rate increases with axillary lymph node dissection. Furthermore, 64% of surgeons change the area of axillary lymph node dissection based on the intraoperative diagnosis of lymph node metastases. We analyzed axillary lymph node dissection in clinically node-positive breast cancer using evidence-based medicine. We recommend that the level I and II axillary dissection be the preferred procedure and that the removal of level III axillary nodes is not necessary for staging. However, if grossly positive nodes are identified intraoperatively, a level III dissection should be carried out to maximize local control.
authors.affiliation: Department of Breast Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Hiroji
authors.initials: H
authors.lastname: Iwata
authors.forename: Shigeto
authors.initials: S
authors.lastname: Miura
mesh_terms: D001365:Axilla; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000401:mortality; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015996:Survival Rate