Internal Mammary Sentinel Node Biopsy in Breast Cancer. Is it Indicated?

Area of Science:

• Oncology
• Surgical Oncology
• Breast Cancer Research

Background:

• Axillary sentinel node biopsy (A-SNB) is standard in breast cancer surgery.
• Internal mammary sentinel node (IM-SN) sampling is not routine but is a potential prognostic factor.
• The clinical role of IM-SN biopsy (IM-SNB) needs further investigation.

Purpose of the Study:

• To investigate the role and clinical impact of internal mammary sentinel node biopsy (IM-SNB) in breast cancer patients.
• To determine the frequency and significance of internal mammary sentinel node involvement.
• To evaluate whether IM-SNB influences therapeutic decisions.

Main Methods:

• Retrospective analysis of 1542 breast cancer patients undergoing sentinel node biopsy (SNB) between 2001 and 2012.
• Detection of internal mammary sentinel nodes (IM-SN) using lymphoscintigraphy, gamma probe, and blue dye mapping.
• Biopsy and pathological examination of detected IM-SNs to identify tumor involvement (macrometastases, micrometastases, isolated tumor cells).

Main Results:

• Internal mammary sentinel nodes (IM-SN) were visualized in 83 patients and successfully biopsied in 77 (93%).
• Tumor involvement in IM-SNs was found in 14 patients (18%), including macrometastases, micrometastases, and isolated tumor cells.
• IM-SN involvement led to changes in therapeutic indications in only 2 cases (2.6%), both involving macrometastases.

Conclusions:

• Internal mammary sentinel node biopsy (IM-SNB) has a limited role in routine breast cancer management.
• The routine use of IM-SNB is not recommended due to infrequent detection of metastases and minimal impact on treatment planning.
• Further research may refine patient selection for IM-SNB in specific clinical scenarios.