Internal Mammary Chain Drainage of Breast Cancer

Krynyckyi, Borys R.; Shim, Jungho; Kim, Chun K.

doi:10.1097/01.sla.0000138728.70176.7f

Cited by 9 publications

(7 citation statements)

References 5 publications

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“…Additionally, accumulating research studies suggest a possible important role of IMA lymph node dissection for staging and treatment of breast cancer. [4][5][6] At the same time, the level of technical achievements regarding video-endoscopic surgical techniques offers today the possibility of minimal invasive access and treatment of a wide range of pathology in almost all anatomical regions of the body while maintaining surgical efficacy. 11 Using a thoracoscopic approach for harvesting of IMA avoids complications such as extensive costal resection, important chest wall retraction, IMA kinking, and coronary steal syndrome, all attributed to the open harvesting of the IMA during MIDCAB procedure.…”

Section: Discussionmentioning

confidence: 99%

“…2 In addition, recent data have shown that the internal mammary lymph nodes (IMN) could play an important role in breast cancer staging and subsequent adjuvant therapy. 4 Patients with early breast cancer have an incidence of IMN positivity of 17-27%, while involvement of these lymph nodes is associated with a worse prognosis. 5 This has led to the development of clinical trials where the surgical removal of the IMN is indicated and subsequently to the need for training in this procedure.…”

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confidence: 99%

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Thoracoscopic approach of the internal mammary artery (IMA): A training model in pigs

Jiga

Cristian²,

Blidișel

et al. 2008

Microsurgery

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Endoscopic internal mammary artery (IMA) approach represents a well-established procedure in coronary bypass surgery. However, such techniques require highly trained skills that need to be mastered in experimental models before taken into the clinic. To attain such skills, our aim was to develop a training model of thoracoscopic approach for harvesting of the IMA in pig. Ten pigs of either sex, weighing 20-28 kg, were used. The thoracic cavity was accessed with the animal in a lateral decubit position, through two ports of 10 mm and 1 of 5 mm, inserted on the anterior and posterior axillary lines immediately below the infrascapular angle into the pleural cavity, and a 30 degrees Hopkins II telescope. The internal mammary artery (IMA) was identified and dissected from its origin in the subclavian artery until its distal part where it becomes the deep superior epigastric artery. Afterward, the arterial segment was clipped and harvested. The mean operative time was 73 min. Postoperative survival at 72 hours was 100% and 90% at 4 weeks. A mean length of 3.2 cm of IMA graft was obtained (2.8-4 cm). The pig IMA has no intercostal branches; thus, the mobilization of the vessel being greatly facilitated. The procedure has two critical steps: the proper trocar insertion and the dissection of the middle one-third of the IMA. Endoscopic-assisted IMA, harvesting in pigs, represents a useful tool for training in minimally invasive heart surgery and supports further development toward other clinical applications.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Thoracoscopic approach of the internal mammary artery (IMA): A training model in pigs

Jiga

Cristian²,

Blidișel

et al. 2008

Microsurgery

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“…Superfi cial vessels run between the dermis and the parenchyma and some run through the breast tissue itself to deeper nodes and into the internal mammary system [26] . Drainage to internal mammary nodes from small breasts (especially in thin and/or young women) is more likely to pass into internal mammary nodes than is drainage from large breasts [27] .…”

Section: Lymphatic Drainagementioning

confidence: 99%

Anatomy and Physiology of the Breast

Johnson

2010

Management of Breast Diseases

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“…[27][28][29][30] Intratumor/perilesional injections are associated with higher internal mammary (IM) identification rate whereas superficial injections very rarely highlight IM nodes. [31] Apart from the site of injection, other factors such as small breast size, medial, and inferior tumors, younger age, and lower body mass index are also associated with higher IM node identification. [31] Identification of IM chain as SLN is a controversial topic as its management and impact on clinical decisions and patient outcome is not clear.…”

Section: Introductionmentioning

confidence: 99%

“…[31] Apart from the site of injection, other factors such as small breast size, medial, and inferior tumors, younger age, and lower body mass index are also associated with higher IM node identification. [31] Identification of IM chain as SLN is a controversial topic as its management and impact on clinical decisions and patient outcome is not clear. [32,33] Superficial injections were found to identify axillary SLN more accurately and hence have replaced the intratumor injections as the preferred site in traditional SLNB procedure.…”

Section: Introductionmentioning

confidence: 99%

Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons

Jha

Deo

Malhotra

2015

ASJO

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Wire Guided Localisation has been the traditional technique for occult breast lesions. However, ROLL has emerged as a safer alternative to WGL approach. ROLL provides an improvement on margin positive rates and offers better pain and cosmetic advantages to the patient combined with a shorter learning curves for both radiologists and surgeons. SNOLL adds to the advantages of the procedure by combining SLNB with ROLL hence offering an economic advantage. The use of ROLL as primary modality for occult lesion localisation is bound to increase with potential to replace WGL as the primary modality for such lesions.

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Internal Mammary Chain Drainage of Breast Cancer

Cited by 9 publications

References 5 publications

Thoracoscopic approach of the internal mammary artery (IMA): A training model in pigs

Thoracoscopic approach of the internal mammary artery (IMA): A training model in pigs

Anatomy and Physiology of the Breast

Radioguided occult lesion localization and sentinel node and occult lesion localization in breast cancer: The future beckons

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