ASO Author Reflections: Implications of Internal Mammary Lymph Node Sampling During Microsurgical Breast Reconstruction

Excerpt

Sampling of the internal mammary nodes is not common practice during free-flap breast reconstruction. However, positive nodes are sometimes found and can have a significant impact on the patient’s treatment necessities and prognosis.1,2 Historically, internal mammary node evaluation wasn performed through an extended mastectomy, which included rib resection to access the lymph nodes. This operation was morbid and finally was abandoned because it failed to add a survival benefit, likely due to the lack of adjuvant therapies offered at the time. We believe patients undergoing free-flap breast reconstruction with the internal mammary arteries as the recipient site should have evaluation of their lymph nodes because it adds no additional morbidity to the surgery. …