Prognostic Significance Of Tumor Size Research Articles

Axillary dissection in breast cancer: When, why, how much, and for how long? Another operation soon to be extinct?

AbstractThe prognostic significance of tumor size and location of the primary tumor in the breast as well as the pathologic status of the axillary lymph nodes in patients with invasive primary breast cancer have been thoroughly studied. A direct adverse relationship between increasing tumor size and prognosis is well established. Likewise, even though 50% of invasive tumors are located in the upper outer quadrant of the breast, it is unusual to find statistically significant differences in survival based on quadrant location alone. Although the American College of Surgeons' (ACS) National Survey in 1978 [1] and even earlier data from Fisher et al. [2] both indicate that women with medial tumors and negative nodes do somewhat worse than patients with lateral tumors and negative nodes, this difference is, at most, 5%. Moreover, the prognosis for patients with positive nodes was not statistically different based on tumor location. However, the likelihood of axillary lymph node involvement is influenced by location of the primary tumor in the breast. In the ACS survey, 43% of patients with tumors in the lateral half of the breast had positive axillary nodes, compared with 35% for patients with medial‐half tumors. Fisher has observed that 52% of patients with lateral‐half tumors had positive nodes, compared with 29% of patients with medial‐half tumors. This tendency occurs independent of tumor size.

Invasive carcinoma of the breast: prognostic significance of tumor size and involved axillary lymph nodes.

The clinical records were reviewed of 1034 patients who had invasive carcinomas of the breast treated with radical mastectomy at Ellis Fischel State Cancer Hospital-Cancer Research Center between 1940 and 1965. There was a correspondence between the size of tumors and both the frequency of axillary nodal involvement and patient survival. Although patients with nodal involvement had lower survival rates than those without, small tumor size was associated with a relatively favorable prognosis within each nodal category. These findings tend to support the value of early diagnosis of breast cancer.