Original CommunicationIntramammary lymph nodes: Patterns of discovery and clinical significance
Section snippets
Methods
Institutional Review Board approval was obtained and a retrospective review was conducted of our breast cancer pathology database to identify all patients in whom an IMLN had been identified between March 1994 and October 2007. Information was retrieved on: clinicopathologic features of the primary neoplasm (type, greatest dimension, grade, presence of lymphovascular invasion, and ER/PR status); axillary lymph node status (number of nodes with metastatic involvement); method of discovery and
Results
Between March 1994 and October 2007, approximately 9,800 operable breast cancers were treated at Mayo Clinic. The average mastectomy rate was 40%. IMLNs were identified in 93 breast specimens in 93 female patients. Thirty-two patients (34%) harbored cancer in IMLNs.
The median age was 68 years (range, 26–106). Of the 93 patients, 33 (35%) were premenopausal, 56 (60%) were postmenopausal, and 4 (5%) were peri-menopausal. Sixty-nine patients (74%) underwent mastectomy, and 24 patients (26%)
Discussion
The clinical implications of metastatic involvement of IMLNs have been debated since 1983, when Egan and McSweeney3 first published their experience. They found a 10% incidence of metastasis in IMLNs found at the time of pathologic evaluation. More recently, Shen et al4 and Guth et al5 have reported IMLN involvement in 28% and 31% of IMLNs respectively. These authors have also demonstrated axillary lymph node disease in 81% and 72%, respectively, of patients with a positive IMLN.
Our 69% rate of
References (12)
- et al.
Lymph nodes in the human female breast: a review of their detection and significance
Hum Pathol
(2001) - et al.
Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node?
Am J Surg
(2006) - et al.
Metastatic intramammary lymph nodes: mammographic and ultrasonographic features
Eur J Radiol
(2001) - et al.
The significance of intramammary nodes in primary breast cancer
Eur J Surg Oncol
(2001) - et al.
Prognostic factors in breast cancer. College of American Pathologists Consensus Statement 1999
Arch Pathol Lab Med
(2000) - et al.
Intramammary lymph nodes
Cancer
(1983)