Breast Cancer: Prognosis in the Presence of One Tumor-Bearing Node in the Axilla

Abstract

Of 1,069 women with breast carcinoma, 183 had one tumor-bearing node in the axilla; a micrometastasis in 72%. Ten years postoperatively their overall survival was worse than that of their node-negative controls (p<0.01). Nodal tumor load alone identified 31 cases at high risk, i.e., under 0.000 1 or over 1.0 cm2. On 10-year followup 18 of them had died, of whom 13 had also been picked out as at special risk on histology. The survival difference between these 31 cases and those with an intermediate tumor load was marked (p<0.0005). Thus on routine nodal investigation 18 of the 49 women who died of breast cancer could have been identified at the time of operation. In this era of early diagnosis it is essential that such cases should not be missed.