OBJECTIVES: * Compare disease-free survival of women with clinically node-negative breast cancer with sentinel lymph node micrometastases treated with surgical resection with or without axillary dissection. * Compare overall survival of patients treated with these regimens. * Assess sites of recurrence, particularly reappearance of disease in the undissected axilla. * Assess long-term surgical complications in patients treated with these regimens. OUTLINE: This is a multicenter study. Patients are stratified according to participating center, menopausal status (pre- vs postmenopausal), and preoperative sentinel node biopsy (yes vs no). Patients are followed every 4 months for 1 year, every 6 months for 4 years, and then annually thereafter.
DISEASE CHARACTERISTICS: * Clinical, mammographic, ultrasonographic, or pathologic diagnosis of unicentric and unifocal breast carcinoma * Largest tumor lesion ≤ 5 cm * Palpable or nonpalpable breast lesion * Preoperative radioactive occult lesion localization, hook wire, or other method of localization required for nonpalpable lesions * Prior (preoperative) or planned (intraoperative) sentinel node biopsy required * At least 1 micrometastatic (i.e., no greater than 2 mm) sentinel lymph node with no extracapsular extension * No clinical evidence of distant metastases * No suspicious manifestation of metastases that cannot be ruled out by x-ray, MRI, or CT scan, including the following: * Skeletal pain of unknown cause * Elevated alkaline phosphatase * Bone scan showing hot spots * No palpable axillary lymph node(s) * No Paget's disease without invasive cancer * Hormone receptor status: * Estrogen receptor and progesterone receptor known PATIENT CHARACTERISTICS: Age * Any age Sex * Female Menopausal status * Any status Performance status * Not specified Life expectancy * Not specified Hematopoietic * Not specified Hepatic * See Disease Characteristics Renal * Not specified Other * Not pregnant or nursing * No other prior or concurrent malignancy except the following: * Adequately treated basal cell or squamous cell skin cancer * Adequately treated carcinoma in situ of the cervix * Adequately treated in situ melanoma * Contralateral or ipsilateral carcinoma in situ of the breast * No psychiatric, addictive, or other disorder that may compromise ability to give informed consent * Geographically accessible for follow-up PRIOR CONCURRENT THERAPY: Biologic therapy * Not specified Chemotherapy * Not specified Endocrine therapy * Not specified Radiotherapy * Not specified Surgery * See Disease Characteristics Other * No prior systemic therapy for breast cancer * More than 1 year since prior chemopreventive agent
are designated in this study