A Meta-Analysis of Internal Mammary Lymph Node Metastasis in Breast Cancer Patients

Abstract

Background: Knowing the status of the internal mammary lymph (IML) nodes is important for accurate staging and appropriate selection of subsequent treatment in breast cancer. We conducted a meta-analysis to clarify the rate of IML node metastasis in breast cancer patients and discussed the importance of this finding. Methods: We retrieved articles from the literature that reported positive rates of IML node metastasis in breast cancer patients. The quality of the selected articles was assessed using the ‘Methodological Index for Non-Randomized Studies'. The heterogeneity was tested, and publication bias was assessed using a funnel plot. Finally, the positive rate of IML node metastasis in breast cancer patients was calculated using the random-effects model. Results: 15 articles met the inclusion criteria and a total of 4,248 patients were included in the analysis. Heterogeneity across the studies was statistically significant (p = 0.014); thus, the random-effects model was used and the calculated positive rate of IML node metastasis was 23% (95% confidence interval (CI), 0.21-0.25). Conclusions: Approximately 23% of the breast cancer patients had IML node metastases, for which the prognosis is generally poor. Accurate staging and integrated treatment are necessary to improve the survival of these patients.

Breast Magnetic Resonance Imaging for Assessment of Internal Mammary Lymph Node Status in Breast Cancer

“…Internal mammary lymph nodes (IMLNs) are a secondary lymphatic drainage area in breast cancer. IMLN metastases occur in 16.7% to 40% of breast cancer patients, who show shorter survival rates than breast cancer patients overall [ 1 ]. While the prognostic significance of IMLN metastasis is well known, the management of IMNLs in breast cancer remains controversial in the field of oncology.…”

Synergistic effects of combined treatment with simvastatin and exemestane on MCF-7 human breast cancer cells

“…Previous studies have demonstrated that exemestane is superior to tamoxifen, with regards to its effects on disease progression, incidences of locoregional and distant relapses, and contralateral breast cancers (2,5). However, despite advances in breast cancer treatment, ~25-40% of patients will eventually develop metastatic disease, which is largely incurable (6). Systemic chemotherapy is currently considered the standard treatment for patients with metastatic breast cancer (7).…”

The effect of internal mammary lymph node biopsy on the therapeutic decision and survival of patients with breast cancer

“…23,25 For that reason, IMLNB did not get popular for a long time. Lymphoscintigraphy studies that were conducted in the 1990s renewed interest in IMLN evaluation.…”

“…17,22 Many studies showed that IMLN positivity is an independent predictor of poorer outcome in patients with breast cancer. 23 In this study, we reviewed our experience at a single institution where IMLN biopsies are performed. The aim of the study was to analyze 72 patients who underwent IMLN biopsy to investigate the rate of nodal positivity, evaluate the association with axillary nodal status, and determine how identification of IMLN metastasis affected staging, management, and survival of patients with breast cancer.…”