Axillary recurrence after intramammary sentinel lymph nodes metastases with capsular extravasation

Abstract

Axillary recurrence is a rare event in patients treated with sentinel lymph node biopsy alone with the majority occurring in the first 5 years after surgery. Intramammary lymph node (IMLN) can be the primary sites of metastasis and sentinel lymph nodes, but the clinical significance, including prognosis and therapeutic approach is yet unclear, even more with capsular extravasation. IMLN metastases are strongly correlated with axillary lymph nodes involvement and therefore a guide for further surgical management of the axillary nodes.

Keywords

Breast cancer / sentinel lymph node / lymph node dissection / metastasis / locoregional neoplasm recurrence

References

[1] Pugliese MS,Cody HS3rd,Gemignani ML.Surgical management of the axilla: do intramammary nodes matter?.Am J Surg2009;198:532-7

[2] De Alcantara Filho PR,Guatelli CS,Bezerra SM.Intramammary sentinel lymph node with capsular extravasation in breast cancer..Ann Surg Treat Res2017;92:376-9 PMCID:PMC5416920

[3] Lee SK,Choi MY,Lee J.The clinical meaning of intramammary lymph nodes..Oncology2013;84:1-5

[4] Bolster MJ,Wauters CA,Meijer JW.Is the sentinel lymph node pathology protocol in breast cancer patients associated with the risk of regional recurrence?.Eur J Surg Oncol2013;39:437-41

[5] Houvenaeghel G,Garbay JR,Cohen M.Survival impact and predictive factors of axillary recurrence after sentinel biopsy..Eur J Cancer2016;58:73-82

[6] Mamounas EP.NSABP breast cancer clinical trials: recent results and future directions..Clin Med Res2003;1:309-26 PMCID:PMC1069061

[7] Donker M,Straver ME,van de Velde CJ.Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial..Lancet Oncol2014;15:1303-10 PMCID:PMC4291166

[8] Bilimoria KY,Hansen NM,Rademaker AW.Comparison of sentinel lymph node biopsy alone and completion axillary lymph node dissection for node-positive breast cancer..J Clin Oncol2009;27:2946-53

[9] Diaz R,Boughey JC,Jakub JW.A positive intramammary lymph node does not mandate a complete axillary node dissection..Am J Surg2012;203:151-5

[10] Ilknur GB,Tülay C,Selma S.The importance of extracapsular extension of axillary lymph node metastases in breast cancer..Tumori2004;90:107-11

[11] Kanyilmaz G,Yavuz BB.The significance of extent of extracapsular extension in patients with T1-2 and N1 breast cancer..Eur J Breast Health2018;14:218-24 PMCID:PMC6170024