Internal mammary sentinel lymph node biopsy in breast cancer: accurate staging and individualized treatment.

Pengfe Qiu; Rongrong Zhao; Binbin Cong; Guoren Yang; Yanbing Liu; Peng Chen; Xiao Sun; Chunjian Wang; Yongsheng Wang

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Internal mammary sentinel lymph node biopsy in breast cancer: accurate staging and individualized treatment.

VernacularTitle:乳腺癌内乳区前哨淋巴结活检术对淋巴分期和个体化治疗的影响
Author: Pengfe QIU ¹ ; Rongrong ZHAO ² ; Binbin CONG ¹ ; Guoren YANG ³ ; Yanbing LIU ¹ ; Peng CHEN ¹ ; Xiao SUN ¹ ; Chunjian WANG ¹ ; Yongsheng WANG ¹
Author Information

1. Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
2. Department of Medicine, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
3. Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
Publication Type:Journal Article
MeSH: Breast; pathology; Breast Neoplasms; pathology; Female; Humans; Learning Curve; Lymph Nodes; pathology; Lymphatic Metastasis; Mammary Arteries; Neoplasm Staging; methods; Neoplasms, Second Primary; Prospective Studies; Sentinel Lymph Node Biopsy; methods
From: Chinese Journal of Oncology 2016;38(1):42-47
CountryChina
Language:Chinese
Abstract:
OBJECTIVEThe aim of this study was to determine the impact of routinely performed internal mammary sentinel lymph node biopsy (IM-SLNB) on the staging and treatment, and to analyze the success rate, complications and learning curve.
METHODSAll patients with biopsy-proven breast cancer who underwent sentinel lymph node biopsy between 2012 and 2014 were included in a prospective analysis. Internal mammary sentinel lymph node biopsy (IM-SLNB) was performed in all patients with IM-SLN visualized on preoperative lymphoscintigraphy and/or detected by intraoperative gamma probe detection. The adjuvant treatment plan was adjusted according to the current guidelines.
RESULTSIn a total of 349 patients, 249 patients (71.1%) showed internal mammary drainage. IM-SLNB was performed in 153 patients with internal mammary drainage, with a success rate of IM-SLNB of 97.4% (149/153). Pleural lesion and internal mammary artery bleeding were found in 7.2% and 5.2% patients, respectively. In 8.1% of patients (12/149) the IM-SLN was tumor positive. In the group of patients who underwent IM-SLNB, lymph node staging was changed in 8.1% of patients, and IMLNs radiotherapy was guided by these results, however, systemic treatment was changed in only 0.7% of the patients.
CONCLUSIONSIM-SLNB has a high successful rate and good safety. Identification of internal mammary metastases through IM-SLNB may provide more accurate staging and guide the tailored internal mammary radiotherapy.
TRIAL REGISTRATIONClinicalTrials. gov, NCT01642511.