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Nathan P. Schneidereit, MD; Noelle Davis, MD; Murray Mackinnon, MSc; Caroline H. Speers; Pauline T. Truong, MD; Ivo A. Olivotto, MD

Arch Surg. 2003;138:832-837.

Hypothesis  Axillary dissection (AD) does not affect recurrence or survival in T1a breast cancer.

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

Setting  Provincial cancer agency.

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

Main Outcome Measures  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).

Conclusion  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.

From the Department of Surgery, Division of General Surgery, University of British Columbia (Drs Schneidereit and Davis), and Department of Surgical Oncology (Mr Mackinnon) and the Breast Cancer Outcomes Unit (Ms Speers), British Columbia Cancer Agency, Vancouver; and the Division of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre and the University of British Columbia, Victoria (Drs Truong and Olivotto).

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