Prognosis of Breast Cancer Related to Intramammary Lymph Nodes

McSweeney, M. B.; Egan, Robert L.

doi:10.1007/978-3-642-82031-1_24

“…Several authors have reported diverse identification rates of iMLNs ranging from 0.2 to 48% [3,5,10,11,12,13,14]. This variability was caused by the use of different detection methods, including autopsy, pathologic review and retrospective chart review.…”

Section: Discussionmentioning

confidence: 99%

The Clinical Meaning of Intramammary Lymph Nodes

Lee¹,

Kim²,

Choi³

et al. 2012

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Objective: The clinical meaning of intramammary lymph nodes (iMLNs) is uncertain. We wanted to describe the clinical characteristics and understand the implications of iMLNs detected by sentinel LN biopsy (SLNB). Methods: We reviewed the clinical, radiological and pathological records of women diagnosed with invasive carcinoma of the breast at the Samsung Medical Center between January 2001 and January 2011. A total of 69 patients were identified, and SLNB was performed in 31 patients. Results: Of the 69 patients included in the study, 22 (31.9%) had metastases in iMLNs. The presence of lymphovascular invasion and the number of axillary LN metastases were associated with iMLN metastasis. Of the 31 patients who underwent SLNB, there were no cases with axillary LN metastasis when axillary SLNB was negative, even in cases of iMLN-positive patients. Of the 10 patients in whom intramammary SLNs (iMSLNs) were detected during SLNB, 8 patients without iMLN metastases were also negative for axillary LNs. Conclusion: Patients with metastatic iMLNs had more aggressive cancers with lymphovascular invasion and increased axillary LN metastases. When iMSLN was detected by SLNB, performing of axillary dissection could be determined by the status of the iMSLN itself.

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“…Por outro lado, a prevalência desse achado na anatomia patológica é de 1 a 28% 7, 15 . As poucas séries de casos relatando o linfonodo IM são provenientes de bancos de dados de serviços com casuística superior a 3.600 pacientes, alcançadas num período superior a cinco anos [8][9][10][11]14,16 .…”

Section: Discussionunclassified

Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora?

Vieira¹,

Viviani²,

Ferreira³

et al. 2012

Rev. Bras. Ginecol. Obstet.

0

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ResumoA pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS) extra-axilar e intramamário (IM) ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação. AbstractThe sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

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“…Em publicações baseadas em bancos de dados, a ocorrência do linfonodo IM varia de 0,6 14 a 2% 8,11 e a ocorrência do LS-IM na ordem de 0,2 10 a 2,6% 13 . Por outro lado, a prevalência desse achado na anatomia patológica é de 1 a 28% 7,15 . As poucas séries de casos relatando o linfonodo IM são provenientes de bancos de dados de serviços com casuística superior a 3.600 pacientes, alcançadas num período superior a cinco anos [8][9][10][11]14,16 .…”

Section: Discussionunclassified

Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora?

Vieira¹,

Viviani²,

Ferreira³

et al. 2012

Rev. Bras. Ginecol. Obstet.

1

0

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ResumoA pesquisa do linfonodo sentinela constitui tratamento padrão para pacientes portadoras de câncer de mama e axila clinicamente negativa. A presença do linfonodo sentinela (LS) extra-axilar e intramamário (IM) ocorre em até 2,6% dos casos, e na presença do LS IM metastático, a positividade axilar pode alcançar até 81%. Na associação do LS IM metastático ao LS axilar não metastático, não há conduta padronizada, visto um limitado número de casos descritos. Adicionamos dois casos à literatura, observando, em um deles, a presença de doença metastática axilar na linfadenectomia complementar. A utilização de nomograma demonstrou que o risco de doença metastática axilar era inferior a 10%, e a adição destes casos à literatura mostrou que, nesta situação, a taxa de doença metastática axilar é de 6,25%. Discutimos os prós e contras da linfadenectomia axilar complementar nesta situação. AbstractThe sentinel lymph node biopsy is a standard treatment for patients with breast cancer and clinically negative axilla lymph node. The presence of an extra-axillary and intra-axillary (IM) sentinel lymph node (SLN) occurs in up to 2.6% of cases. In the presence of a metastatic IM SLN, axillary positivity may occur in up to 81% of cases. Due to the limited number of cases reported, there is no standard treatment for the association of metastatic SLN IM and non-metastatic axillary SLN . We add here two cases to the literature, one of them with metastatic disease in the axilla. The use of a nomogram demonstrated that the risk of axillary metastasis was less than 10% and the addition of these cases to the literature showed that in this situation the rate of axillary metastasis is 6.25%. We discuss the pros and cons of further axillary dissection in this situation.

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Prognosis of Breast Cancer Related to Intramammary Lymph Nodes

Cited by 35 publications

References 2 publications

The Clinical Meaning of Intramammary Lymph Nodes

The Clinical Meaning of Intramammary Lymph Nodes

Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora?

Linfonodo sentinela intramamário comprometido e axila livre: esvaziamento axilar ou conduta conservadora?

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