Objective: The clinical meaning of intramammary lymph nodes (iMLNs) is uncertain. We wanted to describe the clinical characteristics and understand the implications of iMLNs detected by sentinel LN biopsy (SLNB). Methods: We reviewed the clinical, radiological and pathological records of women diagnosed with invasive carcinoma of the breast at the Samsung Medical Center between January 2001 and January 2011. A total of 69 patients were identified, and SLNB was performed in 31 patients. Results: Of the 69 patients included in the study, 22 (31.9%) had metastases in iMLNs. The presence of lymphovascular invasion and the number of axillary LN metastases were associated with iMLN metastasis. Of the 31 patients who underwent SLNB, there were no cases with axillary LN metastasis when axillary SLNB was negative, even in cases of iMLN-positive patients. Of the 10 patients in whom intramammary SLNs (iMSLNs) were detected during SLNB, 8 patients without iMLN metastases were also negative for axillary LNs. Conclusion: Patients with metastatic iMLNs had more aggressive cancers with lymphovascular invasion and increased axillary LN metastases. When iMSLN was detected by SLNB, performing of axillary dissection could be determined by the status of the iMSLN itself.

Hogan BV, Peter MB, Shenoy H, Horgan K, Shaaban A: Intramammary lymph node metastasis predicts poorer survival in breast cancer patients. Surg Oncol 2010;19:11–16.
Guth AA, Mercado C, Roses DF, Hiotis K, Skinner K, Diflo T, Cangiarella J: Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node? Am J Surg 2006;192:502–505.
Shen J, Hunt KK, Mirza NQ, Krishnamurthy S, Singletary SE, Kuerer HM, Meric-Bernstam F, Feig B, Ross MI, Ames FC, Babiera GV: Intramammary lymph node metastases are an independent predictor of poor outcome in patients with breast carcinoma. Cancer 2004;101:1330–1337.
Edge SB, Compton CC: The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 2010;17:1471–1474.
Intra M, Garcia-Etienne CA, Renne G, Trifiro G, Rotmensz N, Gentilini OD, Galimberti V, Sagona A, Mattar D, Sangalli C, Gatti G, Luini A, Veronesi U: When sentinel lymph node is intramammary. Ann Surg Oncol 2008;15:1304–1308.
Diaz R, Degnim AC, Boughey JC, Nassar A, Jakub JW: A positive intramammary lymph node does not mandate a complete axillary node dissection. Am J Surg 2011.
Cox CE, Cox JM, Ramos D, Meade TL: Intramammary sentinel lymph nodes: what is the clinical significance? Ann Surg Oncol 2008;15:1273–1274.
Fujii T, Yajima R, Matsumoto A, Yamaki S, Uchida N, Tsutsumi S, Asao T, Kuwano H: Implication of an intramammary sentinel lymph node in breast cancer: is this a true sentinel node? A case report. Breast Care (Basel) 2010;5:102–104.
Pugliese MS, Stempel MM, Cody HS 3rd, Morrow M, Gemignani ML: Surgical management of the axilla: do intramammary nodes matter? Am J Surg 2009;198:532–537.
Jadusingh IH: Intramammary lymph nodes. J Clin Pathol 1992;45:1023–1026.
Egan RL, McSweeney MB: Intramammary lymph nodes. Cancer 1983;51:1838–1842.
McSweeney MB, Egan RL: Prognosis of breast cancer related to intramammary lymph nodes. Recent Results Cancer Res 1984;90:166–172.
Schmidt WA, Boudousquie AC, Vetto JT, Pommier RF, Alexander P, Thurmond A, Scanlan RM, Jones MK: Lymph nodes in the human female breast: a review of their detection and significance. Hum Pathol 2001;32:178–187.
Rampaul RS, Dale OT, Mitchell M, Blamey RW, Macmillan RD, Robertson JF, Ellis IO: Incidence of intramammary nodes in completion mastectomy specimens after axillary node sampling: implications for breast conserving surgery. Breast 2008;17:195–198.
Nassar A, Cohen C, Cotsonis G, Carlson G: Significance of intramammary lymph nodes in the staging of breast cancer: correlation with tumor characteristics and outcome. Breast J 2008;14:147–152.
Tytler I, Hayes A, Kissin M: Intramammary sentinel nodes in early breast cancer: can we find them and do they matter? Eur J Surg Oncol 2003;29:6–8.
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