Surgical treatment of carcinoma of the breast: III. Pathological finding and probability of relapse.

This is a retrospective review of pathological findings of 462 patients who had mastectomy for carcinoma of the breast during 1971-1980. There is a positive correlation of size of the primary tumor and histological subtypes with the incidence of axillary nodal metastasis. Infiltrating ductal and lobular carcinoma, although less likely than medullary or colloid carcinoma to be 4 cm or greater in size, had a significantly higher incidence of nodal metastasis (and greater chance of having four or more positive nodes). Colloid carcinoma smaller than 4 cm and the less common histological subtypes (comedo, tubular, and papillary carcinomas) rarely metastasizes. Considering only carcinoma of infiltrating ductal, lobular, and medullary types, there is a progressively worsening prognosis with increasing sizes and number of positive axillary lymph nodes. In our series, dividing tumors into three arbitrary subgroups either by size (less than or equal to 2 cm, 2-6 cm, greater than or equal to 6 cm) or number of positive nodes (0-3, 4-9, greater than or equal to 10) gave the most significant separation of prognosis.