Abstract
Background: The purpose of this study was to determine the value of lymphoscintigraphy (LS) for internal mammary sentinel node (IMSN) identification, the metastatic rate, and the change in staging and treatment. Methods: Between 2001 and 2007 a prospective database was obtained of all patients undergoing IMSN biopsies using an open or thoracoscopic approach. Radiotracer injection was peritumoral. Results: Thirty-four patients were included. There was one man. Three had ductal carcinoma in situ. LS showed IMSN in 47.1%. The IMSN biopsy success rate was 91.2%. Seven of the 28 successfully biopsied invasive cancer patients had metastatic IMSNs (25%). Positive IMSNs were associated with positive axillary nodes in 71.4% (P = .036). All patients with positive IMSNs were upstaged and received radiation to the internal mammary chain. In 4 of 28 patients (14%) the chemotherapy plans were probably altered. In univariate and multivariate analyses tumor size, location, nuclear grade, estrogen receptors, progesterone receptors, Her-2, and histology were not significant predictors of positivity. Conclusions: IMSNs were positive in 25% of the invasive cancer patients. All had treatment changes. LS identified less than 50% of IMSNs. There are no good tumor-related predictors of IMSN positivity.
| Original language | English |
|---|---|
| Pages (from-to) | 490-494 |
| Number of pages | 5 |
| Journal | American Journal of Surgery |
| Volume | 196 |
| Issue number | 4 |
| DOIs | |
| State | Published - Oct 1 2008 |
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Keywords
- Breast neoplasms
- Internal mammary nodes
- Lymphoscintigraphy
- Sentinel node biopsy
ASJC Scopus subject areas
- Surgery
Cite this
Internal mammary sentinel node biopsy for breast cancer. / Avisar, Eli; Molina, Manuel A.; Scarlata, Michelino; Moffat, Frederick L.
In: American Journal of Surgery, Vol. 196, No. 4, 01.10.2008, p. 490-494.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Internal mammary sentinel node biopsy for breast cancer
AU - Avisar, Eli
AU - Molina, Manuel A.
AU - Scarlata, Michelino
AU - Moffat, Frederick L
PY - 2008/10/1
Y1 - 2008/10/1
N2 - Background: The purpose of this study was to determine the value of lymphoscintigraphy (LS) for internal mammary sentinel node (IMSN) identification, the metastatic rate, and the change in staging and treatment. Methods: Between 2001 and 2007 a prospective database was obtained of all patients undergoing IMSN biopsies using an open or thoracoscopic approach. Radiotracer injection was peritumoral. Results: Thirty-four patients were included. There was one man. Three had ductal carcinoma in situ. LS showed IMSN in 47.1%. The IMSN biopsy success rate was 91.2%. Seven of the 28 successfully biopsied invasive cancer patients had metastatic IMSNs (25%). Positive IMSNs were associated with positive axillary nodes in 71.4% (P = .036). All patients with positive IMSNs were upstaged and received radiation to the internal mammary chain. In 4 of 28 patients (14%) the chemotherapy plans were probably altered. In univariate and multivariate analyses tumor size, location, nuclear grade, estrogen receptors, progesterone receptors, Her-2, and histology were not significant predictors of positivity. Conclusions: IMSNs were positive in 25% of the invasive cancer patients. All had treatment changes. LS identified less than 50% of IMSNs. There are no good tumor-related predictors of IMSN positivity.
AB - Background: The purpose of this study was to determine the value of lymphoscintigraphy (LS) for internal mammary sentinel node (IMSN) identification, the metastatic rate, and the change in staging and treatment. Methods: Between 2001 and 2007 a prospective database was obtained of all patients undergoing IMSN biopsies using an open or thoracoscopic approach. Radiotracer injection was peritumoral. Results: Thirty-four patients were included. There was one man. Three had ductal carcinoma in situ. LS showed IMSN in 47.1%. The IMSN biopsy success rate was 91.2%. Seven of the 28 successfully biopsied invasive cancer patients had metastatic IMSNs (25%). Positive IMSNs were associated with positive axillary nodes in 71.4% (P = .036). All patients with positive IMSNs were upstaged and received radiation to the internal mammary chain. In 4 of 28 patients (14%) the chemotherapy plans were probably altered. In univariate and multivariate analyses tumor size, location, nuclear grade, estrogen receptors, progesterone receptors, Her-2, and histology were not significant predictors of positivity. Conclusions: IMSNs were positive in 25% of the invasive cancer patients. All had treatment changes. LS identified less than 50% of IMSNs. There are no good tumor-related predictors of IMSN positivity.
KW - Breast neoplasms
KW - Internal mammary nodes
KW - Lymphoscintigraphy
KW - Sentinel node biopsy
UR - http://www.scopus.com/inward/record.url?scp=52049102259&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=52049102259&partnerID=8YFLogxK
U2 - 10.1016/j.amjsurg.2008.06.003
DO - 10.1016/j.amjsurg.2008.06.003
M3 - Article
C2 - 18723148
AN - SCOPUS:52049102259
VL - 196
SP - 490
EP - 494
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 4
ER -