Internal Mammary Lymph Nodes
Identification of metastases to the axillary lymph nodes is a well-recognized prognosticator in patients with invasive breast cancer. Knowledge of axillary lymph node status has long influenced whether adjuvant therapy is offered to these patients in an attempt to decrease the rate of recurrence and prolong survival. The value of staging and treatment of the internal mammary lymph nodes, on the other hand, has remained controversial for more than 100 years. Although evolutionary changes have been made in the treatment of this disease during the last century, the principle of excision of lymphatics draining a solid tumor has remained a fundamental concept in surgical oncology. Halsted first devised the radical mastectomy as an operation designed to remove the breast, as well as the axillary lymph nodes at risk for harboring metastatic tumor. Ironically, even though the internal mammary lymphatics were recognized as a possible route for breast cancer cell dissemination during the conception of this operation, neither of the classical radical mastectomies described by Halsted or Meyer were designed to encompass possible internal mammary node (IMN) metastases.
KeywordsSentinel Lymph Node Radical Mastectomy Internal Mammary Node Internal Mammary Chain Internal Mammary Node Metastasis
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