T1a breast carcinoma and the role of axillary dissection.
OBJECTIVE
Axillary dissection (AD) does not affect recurrence or survival in T1a breast cancer.


METHODS
Cohort study comparing patients who underwent AD and those who did not.


METHODS
Provincial cancer agency.


METHODS
Six hundred ninety-one women with pathologically diagnosed T1a tumors.


METHODS
Rates of axillary metastases stratified according to grade and lymphovascular and/or neural invasion, rates of relapse, and disease-specific survival.


RESULTS
Grade 1, 2, and 3 tumors without lymphovascular and/or neural invasion had axillary nodal involvement rates of 0.7%, 7%, and 7.8% of patients, respectively; with lymphovascular and/or neural invasion, axillary nodes were involved in 9.1%, 39.3%, and 44.4%, respectively. No statistically significant differences were found between the cohorts in relapse rates (P =.70) or survival (P =.84).


CONCLUSIONS
Higher tumor grade and lymphovascular and/or neural invasion increased the rate of nodal metastases in T1a tumors, but AD did not improve relapse rates or breast cancer-specific survival.
Schneidereit
Nathan P
NP
Department of Surgery, University of British Columbia, Vancouver.
Davis
Noelle
N
Mackinnon
Murray
M
Speers
Caroline H
CH
Truong
Pauline T
PT
Olivotto
Ivo A
IA
D001365:Axilla; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate