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Published on: January 20, 2019
Interpectoral nodes as the initial site of recurrence in breast cancer
Ian K Komenaka1, Valerie P Bauer, Freya R Schnabel
1Columbia-Presbyterian Medical Center, Comprehensive Breast Center, Columbia University, New York, NY, USA. ikk2001@columbia.edu
Hypothesis:
Interpectoral nodes can be the initial site of recurrent breast cancer.
Design:
Retrospective review.
Setting:
Comprehensive breast center, located in a university-based tertiary care center.
Patients:
All patients undergoing operations for breast cancer at our breast center from 1995 to 2002 were reviewed.
Main Outcome Measures:
Patients with interpectoral node recurrence as the initial site of recurrent breast cancer were identified.
Results:
During the 8-year period, 4097 patients underwent surgical management for breast cancer. During this time, 4 patients (0.1%) had recurrence at the interpectoral nodes. Three of the 4 patients were node-negative at the original operation. All lesions were mammographically occult. Preoperative needle biopsy was effective in the confirmation of malignancy. All 4 underwent excision without complications.
Conclusions:
Recurrence at the interpectoral nodes can be the initial site of surgical failure. These nodes may represent the site of primary drainage in a percentage of patients. The sentinel node identification technique, therefore, should diminish the number of patients affected by recurrence at this site. In patients with a palpable mass in the infraclavicular location, however, a high index of suspicion should be maintained. Workup should include additional breast imaging and needle biopsy prior to operation.
