obsolete axillary cancer

Definition of Obsolete Axillary Cancer

Obsolete axillary cancer refers to a term that has been replaced by more modern and accurate descriptions in the field of breast cancer staging.

• The term "obsolete" indicates that it is no longer used or considered relevant in current medical practice.
• Axillary cancer, also known as neoplasm of the axilla, was a term used to describe cancers that occurred in the armpit region (axilla).

Reasons for Obsolescence

The use of this term has been discontinued due to advances in breast cancer staging and treatment. Modern staging systems, such as the TNM system, have replaced earlier classification systems.

• The TNM system takes into account the size and extent of the tumor, lymph node involvement, and distant metastasis.
• This more accurate and comprehensive system allows for better patient stratification and treatment planning.

Current Understanding

In current medical practice, axillary cancer is not a recognized or used term. Instead, breast cancer staging focuses on the tumor's characteristics (T), lymph node involvement (N), and presence of distant metastasis (M).

• The focus has shifted to more precise and accurate descriptions of breast cancer, allowing for better patient care and outcomes.

References

• [5] DOID:5097; Synonyms. Axillary neoplasm; neoplasm of axilla (disorder). Definition: References: Obsolete: true; Ontology ...

Axillary Cancer Signs and Symptoms

Axillary cancer, also known as lymphoma or breast cancer that has spread to the armpit area, can exhibit various signs and symptoms. These may include:

• Persistent axillary lymphadenopathy: Swelling in the armpit area that lasts for more than 6 weeks [3].
• Pain or tenderness: Progressive pain or tenderness in the armpit and/or down the arm [5].
• Swollen lymph nodes: Enlargement of lymph nodes under the arm, which can be a sign of cancer spread [8].
• Lumps or bumps: A lump or bump under the arm, which can be caused by swollen lymph nodes, infections, or cysts [8].
• Breast symptoms: Nipple discharge, breast pain, or lumps in the breast area can also be associated with axillary cancer [3].

It's essential to note that these symptoms can also be caused by other conditions, and a proper diagnosis should only be made by a qualified healthcare professional.

References:

• Axillary node clearance is a procedure to remove your lymph nodes to help treat the cancer and to prevent it from coming back in your armpit [7].
• An armpit lump is a swelling or bump under the arm, which can have many causes including swollen lymph nodes, infections, or cysts [8].
• Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy [4].

Based on the provided context, it appears that there are various diagnostic tests used to assess axillary lymph node status in breast cancer patients. Here are some relevant findings:

• Axillary Lymph Node Dissection (ALND): This is a surgical procedure where the axillary lymph nodes are removed and examined for cancer cells. However, its use has decreased over the years due to the evolution of less invasive techniques [5].
• Sentinel Lymph Node Biopsy (SLNB): This is a minimally invasive procedure that involves removing the first lymph node to which cancer cells are likely to spread (the "sentinel" node). It is considered the standard of care for axillary node staging in patients with early breast cancer [1, 2].
• Ultrasound: Ultrasound imaging is widely used to evaluate axillary lymph node status in breast cancer patients. Studies have reported that ultrasound is moderately accurate in detecting metastasis in axillary lymph nodes [6, 7].
• PET/CT and PET Radiomics: These advanced imaging techniques are being explored for their potential in predicting axillary lymph node metastasis (LNM) in early-stage breast cancer. A study aimed to construct an integrated model based on clinicopathology, ultrasound, PET/CT, and PET radiomics for predicting axillary LNM [15].

It's worth noting that the role of axillary surgical staging has evolved over the years, with a decreased prognostic value being observed [5]. As a result, less invasive techniques are being favored.

References:

[1] by OD Gentilini · 2023 · Cited by 179 [2] by OD Gentilini · 2023 · Cited by 179 [5] by G Vanni · 2024 [6] by P Han · 2020 · Cited by 13 [7] by P Han · 2020 · Cited by 13 [15] by ML Mitchell · 2005 · Cited by 38

Current Management of Obsolete Axillary Cancer

The management of obsolete axillary cancer has evolved significantly over the years, with a shift towards less extensive surgery due to the absence of survival benefit and increased morbidity associated with axillary lymph node dissection (ALND) in patients with early-stage breast cancer [1-3].

Tamoxifen Therapy

For patients with nodenegative, ER-positive breast cancers, tamoxifen therapy has been shown to provide substantial benefit [4]. However, the benefit from 5 years of tamoxifen therapy persists through 10 years of follow-up, and no additional advantage is obtained from continuing tamoxifen therapy beyond 5 years [1].

Pertuzumab

In 2013, pertuzumab became the first medicine approved by the FDA for the neoadjuvant treatment of breast cancer. The FDA approved pertuzumab in combination with trastuzumab and chemotherapy for patients with HER2-positive early breast cancer who were found to have residual invasive disease [3].

Local Control

Several randomized clinical trials have demonstrated that local control of the disease can be achieved without axillary lymph node dissection, making it a viable option for patients with obsolete axillary cancer [4]. This approach has been shown to reduce morbidity and improve quality of life for these patients.

Current Recommendations

Considering axillary lymph node dissection mandatory after a metastatic sentinel lymph node in women with HR+ HER2-breast cancer could be an overtreatment due to the low probability of finding pN2 axillary staging in cN0 patients [5]. Most patients who are at risk of having four or more positive lymph nodes usually have other high-risk features, making it essential to consider these factors when deciding on treatment.

References

[1] by B Fisher · 1996 · Cited by 1084 [2] by N Bromham · 2017 · Cited by 154 [3] Oct 10, 2024 [4] by G Vanni · 2024 [5] by G von Minckwitz · 2019 · Cited by 2432

The differential diagnosis of an axillary mass, particularly in the context of obsolete or historical cases of axillary cancer, involves a broad range of possibilities.

Historical Context In the past, axillary masses were often associated with lymphadenopathy, which can be caused by various factors such as infections, haematoma, or metastatic disease. However, with advancements in medical knowledge and diagnostic techniques, the differential diagnosis has expanded to include a wide range of conditions.

Current Differential Diagnosis The current differential diagnosis for an axillary mass includes:

• Skin lesions
• Infections (e.g., cellulitis, abscesses)
• Haematoma
• Lymphadenopathy (hyperplastic, inflammatory, neoplastic or metastatic)
• Accessory breast tissue
• Fibroadenoma
• Fibrocystic change
• Post-operative fluid collections
• Primary breast cancer
• Intramuscular neoplasms

Rare and Obsolete Causes In the context of obsolete axillary cancer, some rare and historical causes that may be considered in the differential diagnosis include:

• Metastatic disease: In the past, metastatic disease from other cancers, such as lung or gastrointestinal cancers, was a consideration in the differential diagnosis of an axillary mass.
• Lymphoma: Lymphomas, particularly those affecting the lymph nodes in the axilla, were also considered in the differential diagnosis of an axillary mass.
• Sarcomas: Sarcomas, including spindle cell malignant neoplasms, were rare but possible causes of an axillary mass.

Important Considerations It is essential to note that the differential diagnosis for an axillary mass can vary depending on the patient's age, sex, and medical history. A thorough evaluation by a healthcare professional, including imaging studies and histopathological examination, is necessary to determine the correct diagnosis.

References:

• [1] The differential diagnosis of an axillary mass is broad, including skin lesions, infections, haematoma, lymphadenopathy (hyperplastic, inflammatory, neoplastic or metastatic), accessory breast tissue, fibroadenoma, fibrocystic change, post-operative fluid collections, primary breast cancer and intramuscular neoplasms. [1]
• [9] The differential diagnosis of an axillary mass is broad, including skin lesions, infections, haematoma, lymphadenopathy (hyperplastic, inflammatory, neoplastic or metastatic), accessory breast tissue, fibroadenoma, fibrocystic change, post-operative fluid collections, primary breast cancer and intramuscular neoplasms. [9]
• [14] The differential diagnosis of spindle cell malignant neoplasm in the axillary region is primary sarcoma of the axillary region versus metastasis from breast primary sarcoma, malignant Phyllodes tumor or sarcomatoid metaplastic carcinoma. [14]

Note: The references provided are based on the search results and may not be up-to-date or accurate in the context of current medical knowledge.