Abstract :
Surgery is the only modality available for the management of the axilla in advanced breast cancer in Nigeria and many developing countries. The benefits of axillary surgery in this group of women has been studied.
Three groups of 25 women with T4 N1–2 M0 breast cancer were managed by total mastectomy and one of three types of primary axillary surgery; en bloc partial (levels I and II) axillary dissection for group A, en bloc level I axillary dissection for group B and discontinuous excision of clinically involved axillary nodes for group C respectively. All three groups received postoperative cytotoxic chemotherapy (cyclophosphamide, methotrexate and 5-fluorouracil) and were then compared in this prospective study.
Group A patients clearly had a superior course in terms of slower development of recurrence progression to M1 disease, less need for hospitalization, and better survival compared to group C patients. It is concluded that primary axillary surgery, in the form of partial or complete axillary dissection, is the best option, where no better modality is available, in the management of the axilla in locally advanced breast cancer.
