Metastases from Involved Lymph Nodes after Removal of Various Primary Tumors

Abstract

From 5 to 8 years after operations on patients with clinical Stage-1 cancers of the breast in which there were no palpable metastases in the axillary nodes, the survival rate of patients treated by radical mastectomies was no higher than that following simple mastectomies with axillary dissections deferred until the metastases became palpable. There was no demonstrable tendency for cancers of the breast in axillary nodes to metastasize from node to node or from node to other organs during the period of observation. Prophylactic radical resection of nodes along with the primary tumors did not effect a higher rate of cure of mice with Sarcoma 1 implanted on their feet, or of hamsters with melanomas on their feet, than did simple removal of the tumors followed by delayed resections of the nodes. There was no tendency, either in mice or hamsters, for the tumors to metastasize from node to node or systemically after the primary tumors were removed. Since results of clinical and laboratory studies show no advantage in prophylactic dissections of apparently uninvolved nodes and since dissection of un-involved nodes increases the morbidity of operations for cancer of the breast, it is suggested that the subject should be studied in a randomized clinical trial.