It appears to be safe to forego axillary dissection in patients with very small invasive breast carcinomas and no palpable axillary nodes.
The rate of axillary metastases in women treated by breast conservation without axillary dissection has proved lower than expected, say specialists at the European Institute of Oncology, Milan, Italy. Only long-term follow-up could show whether axillary radiotherapy should be added to prevent axillary metastases.
The specialists pointed out that although surgical dissection of the axilla is a standard part of breast cancer treatment, it did not by itself improve prognosis. Moreover, most women with small breast cancer and a clinically uninvolved axilla never developed axillary metastases.
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