The Axilla in Breast Cancer

Breast carcinoma: periodicity in presentation of metastatic tumour growth in the axilla

“…It does not, however, fit with the observation that there is no difference in the size of type A-single micrometastases in the two periods, or the lack of size difference in for example type B macrometastases. It is also at variance with the suggestion that the basis for the proliferation in the primary lies in the preceding stromal reaction [19]. Yearly increase in the proliferative activity at the metastatic site, unless switched off soon after the establishment of the deposit, would lead to increase in the tumour load in the second period throughout the life history of the nodal deposits.…”

“…The former is more common in the first part of the year, and is accompanied by poor short-term survival, irrespective of nodal status [17]. This type of metachromatic reaction may thus not only accompany infiltrative growth, but reflect the tumour's potential for metastatic spread [19]. The number of cases with primaries showing such metachromasia varies greatly from year to year [17], so there may also be correlation here between non-metachromatic cycles and the missing colonies that could have filled the gaps.…”

“…The season of presentation has also been linked to survival [17,18]. The finding that the growth form of the primary tends to be infiltrative between January and June [17], and that stromal metachromasia at this time is associated with poor short-term prognosis [17] prompted the suggestion that tumour cell emboli might be more common in the first half of the year [19]. However, the scanty data available indicated that the total tumour load was similar in both periods [20], i.e.…”

Malignant Melanoma of the Skin

“…In such cases 5-year survival rates from 40 to 80% have been report ed [5,6], There is at present no means of identifying patients with occult metastatic disease at presentation. How ever, experience with breast carcinoma has shown that the status of the draining nodes will in many cases reflect the tumor load elsewhere in the body [7]. His tological assessment of the draining nodes is manda tory in breast carcinoma, but is as yet not fully accept- cd in the primary treatment of malignant melanoma, although it has its champions [8,9].…”