Conservative treatment of axillary adenopathy due to probable subclinical breast cancer.

Eleven female patients were treated conservatively by radical radiotherapy to the breast and ipsilateral lymphatics for metastatic adenocarcinoma in an axillary lymph node without clinical or mammographic evidence of a breast cancer. Ten of 11, four of five, and three of four were alive and free of disease 5, 10, and 15 years later, respectively. Of the 11 patients who were followed up for a minimum of five years, three (27%) had local recurrences: one at six, one at 11, and one at 14 years. The latter two recurrences were salvaged by secondary mastectomy. The cosmetic results were excellent and no serious irradiation complications were observed. Mastectomy may not be needed for patients with axillary adenopathy due to a probable subclinical breast cancer, since the long-term prognosis after radiotherapy is good and salvage surgery can be performed if recurrences develop.