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Impact of Identification of Internal Mammary Sentinel Lymph Node Metastasis in Breast Cancer Patients

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Accurate assessment of the internal mammary (IM) nodal basin can impact prognosis and treatment in breast cancer. The goal of this study was to identify characteristics associated with positive IM sentinel lymph nodes (SLNs) and the impact on adjuvant treatment.

Methods

Clinically node-negative breast cancer patients who underwent SLN dissection including removal of IM SLNs were identified and medical records were reviewed. Statistical analysis was performed using Fisher’s exact test and rank-sum tests with a significance level of 0.05.

Results

IM SLNs were removed in 71 patients, 60 (85 %) had negative IM SLNs, whereas 11 (15 %) had positive IM SLNs. Clinicopathologic characteristics were similar between the groups. The majority of patients in both groups had axillary SLNs removed (95 % in the node-negative group vs. 91 % in the node-positive group). Four patients (36 %) with positive IM SLNs had axillary metastasis; thus, IM nodal metastases were the only nodal metastases in 64 % of patients with positive IM SLNs. The identification of IM metastases altered adjuvant therapy in 5 (45 %) patients with positive IM SLNs.

Conclusions

Patients with positive IM SLNs have clinicopathologic features similar to those of patients with negative IM SLNs limiting the ability to predict IM nodal metastasis preoperatively. The identification of IM nodal metastases significantly impacts treatment decisions, especially when IM nodes are the only site of nodal metastasis. Removal of IM SLNs should be considered when lymphoscintigraphy reveals IM drainage.

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Acknowledgement

The University of Texas MD Anderson Cancer Center is supported in part by the National Institutes of Health through Cancer Center Support Grant CA016672.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Abigail S. Caudle MD, MS, Min Yi MD, PhD, Elizabeth A. Mittendorf MD, PhD, Gildy V. Babiera MD, Rosa F. Hwang MD, Funda Meric-Bernstam MD & Kelly K. Hunt MD

  2. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Karen E. Hoffman MD

  3. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Aysegul A. Sahin MD

Authors
  1. Abigail S. Caudle MD, MS
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  2. Min Yi MD, PhD
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  3. Karen E. Hoffman MD
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  4. Elizabeth A. Mittendorf MD, PhD
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  5. Gildy V. Babiera MD
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  6. Rosa F. Hwang MD
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  7. Funda Meric-Bernstam MD
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  8. Aysegul A. Sahin MD
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  9. Kelly K. Hunt MD
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Corresponding author

Correspondence to Kelly K. Hunt MD.

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Caudle, A.S., Yi, M., Hoffman, K.E. et al. Impact of Identification of Internal Mammary Sentinel Lymph Node Metastasis in Breast Cancer Patients. Ann Surg Oncol 21, 60–65 (2014). https://doi.org/10.1245/s10434-013-3276-z

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  • DOI: https://doi.org/10.1245/s10434-013-3276-z

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