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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 1/2014

01-01-2014 | Breast Oncology

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

Authors: Abigail S. Caudle, MD, MS, Min Yi, MD, PhD, Karen E. Hoffman, MD, Elizabeth A. Mittendorf, MD, PhD, Gildy V. Babiera, MD, Rosa F. Hwang, MD, Funda Meric-Bernstam, MD, Aysegul A. Sahin, MD, Kelly K. Hunt, MD

Published in: Annals of Surgical Oncology | Issue 1/2014

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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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Metadata
Title
Impact of Identification of Internal Mammary Sentinel Lymph Node Metastasis in Breast Cancer Patients
Authors
Abigail S. Caudle, MD, MS
Min Yi, MD, PhD
Karen E. Hoffman, MD
Elizabeth A. Mittendorf, MD, PhD
Gildy V. Babiera, MD
Rosa F. Hwang, MD
Funda Meric-Bernstam, MD
Aysegul A. Sahin, MD
Kelly K. Hunt, MD
Publication date
01-01-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 1/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3276-z

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