The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series
- 30 September 2008
- journal article
- Published by Elsevier BV in Annals of Oncology
- Vol. 19 (9), 1553-1560
- https://doi.org/10.1093/annonc/mdn183
Abstract
The ‘regional nodal mapping’, is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3%) representing 27.2% of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0%) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8%). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95% at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.This publication has 21 references indexed in Scilit:
- Tumor Location of the Lower-Inner Quadrant Is Associated with an Impaired Survival for Women With Early-Stage Breast CancerAnnals of Surgical Oncology, 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-UpAnnals of Surgical Oncology, 2006
- Site of Primary Tumor Has a Prognostic Role in Operable Breast Cancer: The International Breast Cancer Study Group ExperienceJournal of Clinical Oncology, 2005
- Role of routine preoperative lymphoscintigraphy in sentinel node biopsy for breast cancerEuropean Journal of Cancer, 2005
- Lymphatic Drainage Patterns From the BreastAnnals of Surgery, 2004
- Surgical approach to internal mammary lymph node biopsyJournal of the American College of Surgeons, 2001
- Clinical relevance of internal mammary node mapping as a guide to radiation therapyThe American Journal of Surgery, 2001
- Postoperative Radiotherapy in High-Risk Premenopausal Women with Breast Cancer Who Receive Adjuvant ChemotherapyThe New England Journal of Medicine, 1997
- Prognosis of Breast Cancer Patients after Mastectomy and Dissection of Internal Mammary NodesAnnals of Surgery, 1985
- Risk of Internal Mammary Lymph Node Metastases and Its Relevance on Prognosis of Breast Cancer PatientsAnnals of Surgery, 1983