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Utility of Internal Mammary Lymph Node Removal When Noted by Intraoperative Gamma Probe Detection

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Abstract

Background: Lymphatic mapping LM for breast cancer has made internal mammary node IMN detection practical and dependable. This study demonstrates the necessity of IMN removal when suggested by intraoperative radioguided surgery detection.

Methods: From April 1998 to July 2000, 1273 patients underwent LM for breast cancer. LM was performed using the combined dye and radiocolloid technique. Patients were scanned operatively with a gamma probe over the IMN area, and most underwent preoperative lymphoscintigraphy. Nodes were removed from patients in whom radioactivity was detected in the internal mammary area.

Results: Thirty of the 1273 2.4% patients mapped had at least one IMN removed. Twenty-two of 30 73.3% had inner quadrant lesions. Five of 30 16.7% patients had IMNs that were positive for metastatic disease. Three of these five had no metastatic spread to the axillary sentinel lymph node SLN. One of thirty 3.3% patients with IMN localization had neither hot nor blue nodes detected in an SLN procedure.

Conclusions: Radioguided SLN detection should be attempted in the IMN basin with all tumors. If an IMN is identified, it should be removed. IMN biopsy is a feasible, low-risk procedure when directed by radioguided LM and provides a guide for radiotherapy for patients with positive IMNs.

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Authors and Affiliations

  1. H. Lee Moffitt Cancer Center and Research Institute at the University of South Florida, 12902 Magnolia Drive, Tampa, Florida, 33612-9497

    Elisabeth Dupont MD, Charles E. Cox MD, Keoni Nguyen BS, Christopher J. Salud BS, Eric S. Peltz BS, George F. Whitehead, Mark D. Ebert BS, Ni Ni Ku MD & Douglas S. Reintgen MD

  2. Assistant Professor of Surgery, Comprehensive Breast Cancer Program, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Dr., Suite 3157, Tampa, FL, 33612

    Elisabeth Dupont MD

Authors
  1. Elisabeth Dupont MD
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  2. Charles E. Cox MD
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  3. Keoni Nguyen BS
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  4. Christopher J. Salud BS
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  5. Eric S. Peltz BS
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  6. George F. Whitehead
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  7. Mark D. Ebert BS
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  8. Ni Ni Ku MD
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  9. Douglas S. Reintgen MD
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Correspondence to Elisabeth Dupont MD.

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Dupont, E., Cox, C.E., Nguyen, K. et al. Utility of Internal Mammary Lymph Node Removal When Noted by Intraoperative Gamma Probe Detection. Ann Surg Oncol 8, 833–836 (2001). https://doi.org/10.1007/s10434-001-0833-7

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  • DOI: https://doi.org/10.1007/s10434-001-0833-7

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