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Nathanson SD et al. – LVI predicted RLN metastasis. LVI also significantly predicted systemic metastasis, but only when the RLN was also positive. Since RLN requires lymphatic invasion, these data support the hypothesis that primary breast cancers often invade lymphatics to gain access to the systemic circulation.

Exclusive Author Commentary
S. David Nathanson, 08/20/09

The ultimate importance of demonstrating the critical involvement of regional lymph node metastasis in systemic dissemination of breast cancer is the potential to revisit the current dogma that axillary lymphadenectomy is merely a staging procedure and not of therapeutic value.

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