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Axillary lymphatic metastasis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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