Should Internal Mammary Lymph Node Biopsy Be a Routine Step in Recurrent Breast Cancer? Report of Three Cases With Negative Axilla and Positive Internal Mammary Node

Stavros E Chatzopoulos, Kasim A Behranwala, Parveen Jayia, Ragheed Al-Mufti R, Susan J Cleator, Dimitri J Hadjiminas

Abstract


Lymph node status is the most important clinicopathological prognostic factor for breast cancer patients and in most breast units it reflects only the axillary lymph nodes. A second often overlooked basin consists of the internal mammary lymph nodes (IMLNs) whose evaluation is not done as a routine step during the staging process. We highlight the need to consider incorporation of IMLNs into a patient's staging by presenting three cases of recurrent breast cancer with negative axilla and positive IMLN, a finding which altered their final management. We suggest that biopsy of IMLN should be a routine step in recurrent breast cancer when axillary lymphatics are disrupted by previous surgery although further research is required to define the optimal management of node positive cases.




doi:10.4021/wjon391w


Keywords


Breast cancer; Loco-regional recurrence; Internal mammary lymph node biopsy

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