The reliability of histologically negative axillary lymph nodes in breast cancer. Preliminary report.

In an effort to evaluate the reliability of negative axillary lymph nodes in breast cancer patients, we did recuts in three levels in order to detect occult metastases. Our material consisted of 50 breast cancer cases with negative axilla. From each lymph node two routine sections were reviewed. Consequently, we examined six additional sections from the recuts. Out of the 50 cases, 7 (14%) had occult metastases in one or more section. Our results suggest that a negative axilla in the routine study can show in a considerable percentage occult metastases corresponding to the number of recuts. This means that a sufficient number of patients have only theoretically negative axillary lymph nodes and for that reason may show a low survival rate and a worse prognosis than the one expected. On the other hand, the need for axillary dissection or the appropriate postoperative treatment for carcinoma of the breast is supported.