International Cancer Conference Journal

, Volume 8, Issue 1, pp 1–6 | Cite as

Multidisciplinary treatment for locally advanced breast cancer with internal mammary lymph node metastasis in an elderly patient

  • Haruko Takuwa
  • Wakako Tsuji
  • Yoshihiro Yamamoto
  • Chikako Yamauchi
  • Fumiaki Yotsumoto
Case report


Internal mammary lymph node (IMLN) metastasis is one of the important prognostic indicators in breast cancer. However, the management for IMLN metastasis is not established. The dissection for IMLN metastasis is not recommended in the National Comprehensive Cancer Network guidelines version3. 2015. Furthermore, radiotherapy including IMLN region and biopsy have attendant risks and hence should be performed with caution. Here, we describe our experience of multidisciplinary treatment for locally advanced breast cancer with IMLN metastasis in an elderly patient. Core-needle biopsy of the breast tumor histologically diagnosed the tumor as estrogen receptor positive, progesterone receptor positive, human epidermal growth factor receptor-2 negative, and high Ki-67 labeling index. IMLN swelling was detected by ultrasonography and breast cancer metastasis was diagnosed by fine-needle aspiration cytology. The patient underwent mastectomy and axillary lymph node dissection, followed by postmastectomy radiation therapy. Systemic therapy using tegafur plus uracil (UFT®; Taiho Pharmaceutical Co., Ltd, Tokyo, Japan) and letrozole was beneficial treatment for disease control.


Breast cancer Internal mammary lymph node metastasis Multidisciplinary therapy 


Compliance with ethical standards

Conflict of interest

No conflicts of interest relevant to this article are reported.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from the patient in this study.


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Copyright information

© The Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Department of Breast SurgeryShiga General HospitalMoriyamaJapan
  2. 2.Department of PathologyShiga General HospitalMoriyamaJapan
  3. 3.Department of Radiation OncologyShiga General HospitalMoriyamaJapan

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