Prognostication for the patient undergoing radical mastectomy for carcinoma is based primarily on involvement of the axillary lymph nodes removed at time of dissection. The practical importance of this method need only be mentioned here, for most surgeons realize that when cancer of the breast is still limited to the breast itself the chances of being permanently cured of that lesion are decidedly better than if there is even minimal spread to axillary nodes.
The converse is also true; i. e., the patient whose operative specimen shows metastatic axillary involvement, particularly if several nodes are involved, has far poorer chance of permanent cure. Whether the primary lesion is really limited to the breast is difficult, if not impossible, to prove; however, the converse provides us with a relatively easy, rapid, inexpensive, and dependable method of judging the patient's course.
Although Monroe4 was able to relate better five-year results to
PERKINSON NG, BRANDES WW, SHEPARD FP. Axillary Node Examination in Breast Cancer: Clearing and Sectioning Technique in Search of Metastasis. AMA Arch Surg. 1956;73(5):828–832. doi:10.1001/archsurg.1956.01280050096018
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