The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series

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Abstract

The 'regional nodal mapping' is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3%) representing 27.2% of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0%) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8%). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95% at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.

Original languageEnglish
Pages (from-to)1553-1560
Number of pages8
JournalAnnals of Oncology
Volume19
Issue number9
DOIs
Publication statusPublished - 2008

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Breast
Radiotherapy
Breast Neoplasms
Neoplasm Metastasis
Carcinoma
Biopsy
Survival

Keywords

  • Axillary lymph nodes
  • Breast cancer
  • Internal mammary nodes

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

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title = "The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series",
abstract = "The 'regional nodal mapping' is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3{\%}) representing 27.2{\%} of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0{\%}) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8{\%}). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95{\%} at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.",
keywords = "Axillary lymph nodes, Breast cancer, Internal mammary nodes",
author = "Umberto Veronesi and P. Arnone and P. Veronesi and V. Galimberti and A. Luini and N. Rotmensz and E. Botteri and Ivaldi, {G. B.} and Leonardi, {M. C.} and G. Viale and A. Sagona and G. Paganelli and R. Panzeri and R. Orecchia",
year = "2008",
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T1 - The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series

AU - Veronesi, Umberto

AU - Arnone, P.

AU - Veronesi, P.

AU - Galimberti, V.

AU - Luini, A.

AU - Rotmensz, N.

AU - Botteri, E.

AU - Ivaldi, G. B.

AU - Leonardi, M. C.

AU - Viale, G.

AU - Sagona, A.

AU - Paganelli, G.

AU - Panzeri, R.

AU - Orecchia, R.

PY - 2008

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N2 - The 'regional nodal mapping' is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3%) representing 27.2% of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0%) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8%). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95% at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.

AB - The 'regional nodal mapping' is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3%) representing 27.2% of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0%) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8%). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95% at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.

KW - Axillary lymph nodes

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