Comprehensive review of the management of internal mammary lymph node metastases in breast cancer

Abstract

At the suggestion of Sampson Handley, Philip Stibbe, 1 Stibbe E The internal mammary lymphatic glands. J Anat. 1918; 52 : 257-259 PubMed Google Scholar in 1918, characterized the spread of breast cancer to the internal mammary lymph node (IMN) chain as a pattern of metastasis. In 1952, Wangensteen 2 Wangensteen O.H Super-radical operation for breast cancer in patients with lymph node involvement. Proceedings of the Second National Cancer Conference, Cincinnati, OH. 1952; : 230-242 Google Scholar published the technique of extended radical mastectomy. This technique, developed in an attempt to increase local control and survival in breast cancer, combined the classic radical mastectomy with resection of the IMN chain from the fifth intercostal space to the base of the neck. Early investigations in the 1960s and 1970s focused on the significance of IMN metastases, but the extended radical mastectomy was subsequently abandoned when prospective, randomized trials failed to demonstrate a significant increase in survival.