Internal mammary sentinel node biopsy for breast cancer

American Journal of Surgery
Eli AvisarFrederick L Moffat

Abstract

The purpose of this study was to determine the value of lymphoscintigraphy (LS) for internal mammary sentinel node (IMSN) identification, the metastatic rate, and the change in staging and treatment. Between 2001 and 2007 a prospective database was obtained of all patients undergoing IMSN biopsies using an open or thoracoscopic approach. Radiotracer injection was peritumoral. Thirty-four patients were included. There was one man. Three had ductal carcinoma in situ. LS showed IMSN in 47.1%. The IMSN biopsy success rate was 91.2%. Seven of the 28 successfully biopsied invasive cancer patients had metastatic IMSNs (25%). Positive IMSNs were associated with positive axillary nodes in 71.4% (P = .036). All patients with positive IMSNs were upstaged and received radiation to the internal mammary chain. In 4 of 28 patients (14%) the chemotherapy plans were probably altered. In univariate and multivariate analyses tumor size, location, nuclear grade, estrogen receptors, progesterone receptors, Her-2, and histology were not significant predictors of positivity. IMSNs were positive in 25% of the invasive cancer patients. All had treatment changes. LS identified less than 50% of IMSNs. There are no good tumor-related predictors of IMSN po...Continue Reading

Citations

Aug 22, 2009·Nuclear Medicine Communications·Anna Domènech-VilardellJosep Martín-Comín
Sep 21, 2013·Annals of Surgical Oncology·Abigail S CaudleKelly K Hunt
Sep 21, 2013·Annals of Surgical Oncology·Jennifer L GnerlichDavid J Winchester
Jul 21, 2009·International Journal of Radiation Oncology, Biology, Physics·Carmen AresAntony J Lomax
Apr 22, 2016·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·José Roberto Morales PiatoEdmund Chada Baracat
Jan 7, 2011·Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research·Qingqing HeXueliang Li

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