This series of 1,154 women with unilateral breast carcinoma was treated by modified radical mastectomy with axillary dissection. Histological staging of nodal tumour growth in the axilla distinguished 4 populations in which the numbers of patients presenting for operation over the months of the year differed markedly. The findings are used to develop a hypothesis on nodal tumour growth in which the length of time needed to complete the growth sequence, from the entry of a micrometastasis to exit of tumour cells via the efferent nodal vessels, could be estimated. The results suggest that the time-span may be as much as 3 years, and probably more.
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