The Clinical Meaning of Intramammary Lymph Nodes

Lee, Se Kyung; Kim, Sang-Min; Choi, Moon Young; Kim, Jiyoung; Lee, Jeonghui; Jung, Seung Pil; Choe, Jun Ho; Kim, Jung Han; Kim, Jee Soo; Kil, Won Ho; Lee, Jeong Eon; Nam, Seok Jin

doi:10.1159/000340016

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…They are involved in a variety of clinical situations, including benign lesions, tumor metastases, breast lymphomas and breast cancer, where their importance is not fully established. Nevertheless, there is evidence that IMLNs are an independent factor for poor prognosis, and they may change therapeutic decisions [3] . Patients with metastatic IMLNs had more aggressive cancers with lymphatic and vascular invasion as well as increased axillary lymph node metastases [4] .…”

Section: Discussionmentioning

confidence: 99%

Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

Filho¹,

Bezerra²

2019

JCMT

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Axillary recurrence is a rare event in patients treated with sentinel lymph node biopsy alone with the majority occurring in the first 5 years after surgery. Intramammary lymph node (IMLN) can be the primary sites of metastasis and sentinel lymph nodes, but the clinical significance, including prognosis and therapeutic approach is yet unclear, even more with capsular extravasation. IMLN metastases are strongly correlated with axillary lymph nodes involvement and therefore a guide for further surgical management of the axillary nodes.

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Section: Discussionmentioning

confidence: 99%

Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

Filho¹,

Bezerra²

2019

JCMT

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“…Their role in lymphatic drainage of breast regions is important, although it is not known if they represent true sentinel nodes or if lymphatic drainage to them comes from ectopic, independently developed pathways. Their incidence in various studies ranges between 0.7% and 48% [ 6 7 ] and can be found in all breast quadrants. IMLNs are involved in a variety of clinical situations, including benign situations, tumor metastases, breast lymphomas, and breast cancer, where their importance is not fully established.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, there is evidence that IMLNs are an independent factor for poor prognosis, and they may change therapeutic decisions. Patients with metastatic IMSLNs had more aggressive cancers with lymphatic and vascular invasion as well as increased axillary lymph node metastases [ 6 ]. The use of axillary SLN biopsy accurately represents the disease status of the axilla in cases of positive IMSLN, and the use of nomograms demonstrated that the risk of axillary metastasis was less than 10% [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Intramammary sentinel lymph node with capsular extravasation in breast cancer

et al. 2017

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Sentinel lymph node biopsy has been developed as the standard of treatment in breast cancer. Status of axillary sentinel lymph node is known to be a significant prognostic factor. Nevertheless, involvement of an intramammary lymph node with metastasis in breast cancer is a rare radiological and clinical presentation, and with extracapsular extravasation even more uncommon. Historically, reported series of patients with intramammary lymph node diagnosed by final histological examination are small in number and clinical significance of metastasis is still unclear. Here, we report a case of conservative breast cancer surgery with 3 intramammary sentinel lymph nodes containing metastasis and extracapsular extravasation. After multidisciplinary consensus, the patient was surgically reapproached with mastectomy. Even though the 3 intramammary sentinel lymph nodes were positive for metastases, pathology examination did not reveal any signs of malignancy in the mastectomy specimen.

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“…Other in ammatory conditions such as tuberculosis have also been reported. [1] Although IMLNs can be located in any part of the breast, they are most commonly found in the upper outer quadrant. The prevalence of IMLNs has been reported to range between 1% and 28% [2 ].…”

Section: Imlns Have Received Little Attention Compared To Axlns As Pomentioning

confidence: 99%

Intra-mammary Lymph Nodes, an Overlooked Prognostic Tool?

Hashem¹,

Moez²,

Rozeka³

et al. 2020

Preprint

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BackgroundDue to the high variability of incidence and prevalence of intra-mammary lymph nodes(IMLNs), they might be overlooked during clinical and radiological examinations. Properly characterizing pathological IMLNs and detecting the factors that might influence their prevalence in different stages of breast cancer, might aid in proper therapeutic decision making and could be of possible prognostic value. Methods Medical records were reviewed for all breast cancer patients treated at the National Cancer Institute of Cairo University between 2013-2019. Radiological, pathological and surgical data were studied.ResultsIntra-mammary lymph nodes were described in the final pathology reports of 100 patients. Five cases had benign breast lesion. Three cases had phylloides tumors and two cases had duct carcinoma in situ. All ten cases were excluded. The remaining 90 cases had all invasive breast cancer and were divided into two groups. One group for patients with malignant IMLNs (48) and another for patients with benign IMLNs (42). Pathological features of the malignant IMLN group included larger mean tumour size (4.7 cm) , larger mean size of the IMLN (1.4 cm), higher incidence of lymphovascular invasion( 65.9%) and a higher rate of extracapsular extension in axillary lymph nodes (57.4%). All these criteria were statistically significant. In addition the pathological N stage was significantly higher in the malignant IMLNs group.ConclusionIntra-mammary lymph nodes are frequently overlooked by clinicians. More effort should be done to detect them during preoperative imaging, and during pathological processing of specimens. A suspicious IMLN should be biopsied by FNAC . Malignant IMLN are associated with advanced pathological features and should be removed during surgery.

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The Clinical Meaning of Intramammary Lymph Nodes

Cited by 11 publications

References 30 publications

Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

Intramammary sentinel lymph node with capsular extravasation in breast cancer

Intra-mammary Lymph Nodes, an Overlooked Prognostic Tool?

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