Top

Published in:

01-10-2006

Clinical and Therapeutic Importance of Sentinel Node Biopsy of the Internal Mammary Chain in Patients with Breast Cancer: A Single-Center Study with Long-Term Follow-Up

Authors: Paulo Carcoforo, MD, Davide Sortini, MD, Luciano Feggi, MD, Carlo V. Feo, MD, Giorgio Soliani, MD, Stefano Panareo, MD, Stefano Corcione, MD, Patrizia Querzoli, MD, Konstantinos Maravegias, MD, Serena Lanzara, MD, Alberto Liboni, MD

Published in: Annals of Surgical Oncology | Issue 10/2006

Abstract

Background

We evaluated the incidence of sentinel lymph nodes (SLNs) in the internal mammary chain, calculated the lymphoscintigraphy and surgical detection rates, and evaluated the clinical effect on staging and the therapeutic approach in patients with breast cancer.

Methods

The study involved 741 women diagnosed with breast cancer eligible for the SLN technique. Lymphoscintigraphy was performed on the day before the operation by peritumoral injection of ^99mTc-labeled nanocolloid. During the operation, a gamma probe was used to detect the SLN, which was then removed.

Results

A total of 719 SLNs were found in the axillary chain and 72 in the internal mammary chain. Preoperative lymphoscintigraphy showed 107 hot spots in the internal mammary chain, but only 72 SLNs in 65 patients were identified by the gamma probe and then removed with no complications. Of these 65 patients, 10 had a positive internal mammary chain SLN on final pathologic examination, whereas 55 patients had ≥1 negative SLNs on final pathologic analysis. Thirty-five (53%) of 65 patients had also an axillary SLN, but only 5 patients (8%) had a positive SLN on pathologic analysis.

Conclusions

Evaluation of the SLNs in the internal mammary chain may provide more accurate staging in breast cancer patients. If an internal mammary sampling is not performed, patients may be understaged. This technique may allow better selection of those patients who will be submitted to adjuvant locoregional radiotherapy.

Aarsvold JN, Alazraki NP. Update on detection of sentinel lymph nodes in patients with breast cancer. Semin Nucl Med 2005;35:116–28CrossRefPubMed

Reintgen D, Cruse CW, Wells K, et al. The orderly progression of melanoma nodal metastases. Ann Surg 1994;6:759–67CrossRef

Veronesi U, Cascinelli N, Bufalino R, et al. Risk of internal mammary lymph nodes metastases and its relevance on prognosis of breast cancer patients. Ann Surg 1983;198:681–4CrossRefPubMed

Carcoforo P, Sortini D, Soliani G, Basaglia E, Feggi L, Liboni A. Accuracy and reliability of sentinel node biopsy in patients with breast cancer. Single center study with long term follow-up. Breast Cancer Res Treat 2006; 95:111–6CrossRefPubMed

Farrús B, Vidal-Sicart S, Velasco M, et al. Incidence of internal mammary node metastases after a sentinel lymph node technique in breast cancer and its implication in the radiotherapy plan. Int J Radiat Oncol Biol Phys 2004;60:715–21PubMed

Freedman GM, Fowble BL, Nicolaou N, et al. Should internal mammary lymph nodes in breast cancer be a target for the radiation oncologist? Int J Radiat Oncol Biol Phys 2000;46:805–14PubMed

Allweis TM, Badriyyah M, Bar Ad V, Cohen T, Freund HR. Current controversies in sentinel lymph node biopsy for breast cancer. Breast 2003;12:163–71CrossRefPubMed

Noguchi M, Tsugawa K, Miwa K. Internal mammary chain sentinel lymph node identification in breast cancer. J Surg Oncol 2000;73:75–80CrossRefPubMed

Johnson N, Soot L, Nelson J, et al. Sentinel node biopsy and internal mammary lymphatic mapping in breast cancer. Am J Surg 2000;179:386–8CrossRefPubMed

10.

Estourgie S, Nieweg OE, Valdés Olmos RA, Rutgers EJ, Kroon BB. Lymphatic drainage patterns from the breast. Ann Surg 2004;239:232–7CrossRefPubMed

11.

Galimberti V, Veronesi P, Arnone P, et al. Stage migration after biopsy of internal mammary chain lymph nodes in breast cancer patients. Ann Surg Oncol 2002;9:924–8CrossRefPubMed

12.

Paganelli G, Galimberti V, Trifiro G, et al. Internal mammary node lymphoscintigraphy and biopsy in breast cancer. Q J Nucl Med 2002;46:138–44PubMed

13.

Uren RF, Howman-Giles R, Chung D, Thompson JF. Nuclear medicine aspects of melanoma and breast lymphatic mapping. Semin Oncol 2004;31:338–48CrossRefPubMed

14.

Feggi L, Basaglia E, Corcione S, et al. An original approach in the diagnosis of early breast cancer: use of the same radiopharmaceutical for both non-palpable lesions and sentinel node localisation. Eur J Nucl Med 2001;28:1589–96CrossRefPubMed

15.

Nieweg O, Estourgie S, van Rijk M, Kroon BB. Rationale for superficial injection techniques in lymphatic mapping in breast cancer patients. J Surg Oncol 2004;87:153–6CrossRefPubMed

16.

Ortega M, Vidal-Sicart S, Zanón G, et al. Comparative study of the different radiotracer administration route to locate the sentinel node in breast cancer. Rev Esp Med Nucl 2004;23:153–61CrossRefPubMed

17.

Tanis P, Nieweg OE, Valdés Olmos RA, Kroon BB. Anatomy and physiology of lymphatic drainage of the breast from the perspective of sentinel node biopsy. J Am Coll Surg 2001;192:399–409CrossRefPubMed

18.

Jakub JW, Cox CE, Pipas AW, Gardner M, Pendas S, Reintgen DS. Controversial topics in breast lymphatic mapping. Semin Oncol 2004;31:324–32CrossRefPubMed

19.

van der Ent FW, Kengen RA, van de Pol HA, Povel JA, Stroeken HJ, Hoofwijk AG. Halsted revisited: internal mammary sentinel lymph node biopsy in breast cancer. Ann Surg 2001;34:79–84

20.

Paredes P, Vidal-Sicart S, Zanon G, et al. Clinical relevance of sentinel lymph nodes in the internal mammary chain in breast cancer patients. Eur J Nucl Med Mol Imaging 2005; 32:1283–7CrossRefPubMed

21.

Montgomery LL, Thorne AC, Van Zee KJ, et al. Isosulfan blue dye reactions during sentinel lymph node mapping for breast cancer. Anesth Analg 2002;5:385–8CrossRef

22.

Simmons R, Thevarajah S, Brennan MB, Christos P, Osborne M. Methylene blue dye as an alternative to isosulfan blue dye for sentinel lymph node localization. Ann Surg Oncol 2003;10:242–7CrossRefPubMed

23.

Cserni G, Szekeres JP. Internal mammary lymph nodes and sentinel node biopsy in breast cancer. Surg Oncol 2001;10:25–33CrossRefPubMed

24.

Benamor M, Nos C, Fréneaux P, Clough KB. Impact of internal mammary sentinel node imaging in breast cancer. Clin Nucl Med 2002;28:375–8CrossRef

Title: Clinical and Therapeutic Importance of Sentinel Node Biopsy of the Internal Mammary Chain in Patients with Breast Cancer: A Single-Center Study with Long-Term Follow-Up
Authors: Paulo Carcoforo, MD
Davide Sortini, MD
Luciano Feggi, MD
Carlo V. Feo, MD
Giorgio Soliani, MD
Stefano Panareo, MD
Stefano Corcione, MD
Patrizia Querzoli, MD
Konstantinos Maravegias, MD
Serena Lanzara, MD
Alberto Liboni, MD
Publication date: 01-10-2006
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 10/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9062-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Clinical and Therapeutic Importance of Sentinel Node Biopsy of the Internal Mammary Chain in Patients with Breast Cancer: A Single-Center Study with Long-Term Follow-Up

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 10/2006

Postresectional Adjuvant Intraportal Chemotherapy in Patients with Hepatocellular Carcinoma: A Case-Control Study

ASCO/SSO Review of Current Role of Risk-Reducing Surgery in Common Hereditary Cancer Syndromes

Selection of Patients for Resection of Hepatic Colorectal Metastases: Expert Consensus Statement by Charnsangavej et al.

Chemotherapy and Regional Therapy of Hepatic Colorectal Metastases: Expert Consensus Statement

AHPBA/SSO/SSAT Consensus Conference on Hepatic Colorectal Metastases: Rationale and Overview of the Conference

Chemotherapy and Regional Therapy of Hepatic Colorectal Metastases: Expert Consensus Statement by Bartlett et al.