De Alcantara Filho Paulo Roberto, Curi Carla, Guatelli Camila Souza, Osorio Cynthia Aparecida B de Toledo, Bezerra Stephania Martins, Soares Fernando Augusto, Makdissi Fabiana Baroni
Department of Breast Surgery, AC Camargo Cancer Center, São Paulo, Brazil.
Department of Radiology, AC Camargo Cancer Center, São Paulo, Brazil.
Ann Surg Treat Res. 2017 May;92(5):376-379. doi: 10.4174/astr.2017.92.5.376. Epub 2017 Apr 27.
Sentinel lymph node biopsy has been developed as the standard of treatment in breast cancer. Status of axillary sentinel lymph node is known to be a significant prognostic factor. Nevertheless, involvement of an intramammary lymph node with metastasis in breast cancer is a rare radiological and clinical presentation, and with extracapsular extravasation even more uncommon. Historically, reported series of patients with intramammary lymph node diagnosed by final histological examination are small in number and clinical significance of metastasis is still unclear. Here, we report a case of conservative breast cancer surgery with 3 intramammary sentinel lymph nodes containing metastasis and extracapsular extravasation. After multidisciplinary consensus, the patient was surgically reapproached with mastectomy. Even though the 3 intramammary sentinel lymph nodes were positive for metastases, pathology examination did not reveal any signs of malignancy in the mastectomy specimen.
前哨淋巴结活检已发展成为乳腺癌的标准治疗方法。腋窝前哨淋巴结状态是一个重要的预后因素。然而，乳腺癌患者乳腺内淋巴结转移是一种罕见的影像学和临床表现，伴有包膜外渗血的情况更为少见。从历史上看，经最终组织学检查确诊的乳腺内淋巴结转移患者系列报道数量较少，转移的临床意义仍不明确。在此，我们报告一例保守性乳腺癌手术病例，该患者有3枚乳腺内前哨淋巴结发生转移且伴有包膜外渗血。经多学科会诊后，患者接受了乳房切除术。尽管这3枚乳腺内前哨淋巴结转移呈阳性，但病理检查在乳房切除标本中未发现任何恶性迹象。
