Fig. 4.

Low grade invasive tumor is seen from axillary fat without adjacent residual and apparent lymph node structure. Should this be counted as positive lymph node or a carcinoma arising in axillary breast tissue? Based on the 6th edition, cancerous nodules in the axillary fat without evidence of residual lymph node tissue should be classified as positive axillary lymph nodes. There is no normal breast tissue or ductal carcinoma in situ around this tumor. Is this axillary breast tissue with carcinoma, totally effaced lymph node with metastatic carcinoma or extensive extracapsular invasion? Many pathologists do not classify cancerous nodules in axilla as lymph node metastases.