Braue Kaela, Baker Caroline, Lippey Jocelyn
St Vincent's Hospital Clinical School, The University of Melbourne, Melbourne, Victoria, Australia.
Breast Surgery Unit, St Vincent's Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2023 Jan;93(1-2):59-64. doi: 10.1111/ans.17982. Epub 2022 Aug 23.
Early breast cancer staging involves radiological and pathological evaluation of the tumour and regional lymph nodes. The internal mammary nodes (IMN) are an important site of possible metastasis and influence disease stage and prognosis. However, the recommendation for routine IMN assessment remains unclear. Internal mammary sentinel lymph node biopsy (SLNB) is associated with increased morbidity and an unknown survival benefit. Furthermore, the IMN are traditionally thought to be involved only synchronous with, or following, axillary node (AXN) metastasis. The aim of this review is to determine the prevalence of IMN metastasis in patients with axilla-negative early breast cancer. A narrative review of studies assessing IMN metastasis was performed. The literature search was completed using the database Medline (Ovid). Twenty-two retrospective studies were identified. The studies included data from SLNB, US, MRI, PET/CT and opportunistic biopsy during free-flap reconstruction (FFR). The prevalence of isolated IMN metastasis ranged from 1.2% to 17.9%.
早期乳腺癌分期涉及对肿瘤及区域淋巴结进行放射学和病理学评估。内乳淋巴结（IMN）是可能发生转移的重要部位，会影响疾病分期和预后。然而，对于常规评估IMN的建议仍不明确。内乳前哨淋巴结活检（SLNB）会增加发病率，且生存获益不明。此外，传统上认为IMN仅在腋窝淋巴结（AXN）转移同步或之后才会受累。本综述的目的是确定腋窝阴性早期乳腺癌患者中IMN转移的发生率。对评估IMN转移的研究进行了叙述性综述。使用Medline（Ovid）数据库完成了文献检索。确定了22项回顾性研究。这些研究纳入了来自SLNB、超声、磁共振成像、正电子发射断层扫描/计算机断层扫描（PET/CT）以及游离皮瓣重建（FFR）期间的机会性活检的数据。孤立性IMN转移的发生率在1.2%至17.9%之间。
