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Axillary lymphatic metastasis

Authoring team

Axillary lymph nodes are the most important site for regional spread of breast cancer. The presence of metastasis is the single most important prognostic index of breast cancer - see submenu.

The larger the primary tumour, the greater is the risk of metastasis to axillary nodes:

  • primary less than 2cm diameter - incidence of spread is 15-20%
  • 2-5cm diameter - incidence 30-40%
  • >5cm diameter - incidence >45%

However, there are two practical problems:

  • clinical assessment of axillary nodes yields a high false positive and false negative rate
  • histological identification of nodes and tumour within nodes is highly operator-dependent

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