| Abstract | BACKGROUND: The internal mammary lymph nodes (IMN) have received little attention in recent years, yet are a well-documented site of metastasis and a major prognostic factor in early-stage breast cancer. METHODS/RESULTS: Ten-year follow-up of the final 195 patients treated by extended radical mastectomy (ERM) in this practice (selected largely on the basis of medial tumor location, and comprising 15% of all patients treated from 1965 to 1978) found IMN+ in 24% of all cases: 36% of AX+ versus 18% of AX- patients (p = 0.0023). In a multivariate analysis, the disease-free survival impact of IMN+ (p = 0.004) was second only to axillary node involvement (p < 0.0005), and surpassed tumor size (p = 0.077). IMN+ was equally frequent for tumors less than, or greater than, 2 cm (24%), and was not significantly related to patient age. Among AX- patients, there was a twofold greater risk of recurrence or death at 10 years for IMN+ than for IMN-. Among T1N0 patients, 19.6% were IMN+. CONCLUSIONS: Failure to consider IMN status in the steadily enlarging cohort of T1N0 breast cancers may result in the undertreatment of a significant proportion of stage I patients. Systemic adjuvant therapy should be considered for T1N0 patients with central or medial tumors. |
| Authors | H S Cody 3rd, J A Urban
(Affiliation: Department of Surgery, New York Hospital-Cornell Medical Center, New York.)
|
| Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 2
Issue 1
Pg. 32-7
(Jan 1995)
ISSN: 1068-9265 [Print] UNITED STATES |
| PMID | 7834452
(Publication Type: Journal Article)
|
| Topics |
- Adult
- Age Factors
- Aged
- Axilla
(pathology)
- Breast
(pathology)
- Breast Neoplasms
(pathology, surgery)
- Carcinoma, Ductal, Breast
(pathology, secondary, surgery)
- Carcinoma, Lobular
(pathology, secondary, surgery)
- Cause of Death
- Cohort Studies
- Combined Modality Therapy
- Disease-Free Survival
- Female
- Follow-Up Studies
- Humans
- Lymph Nodes
(pathology)
- Lymphatic Metastasis
(pathology)
- Mastectomy, Extended Radical
- Middle Aged
- Multivariate Analysis
- Neoplasm Recurrence, Local
- Neoplasm Staging
- Prognosis
- Risk Factors
|