Open AccessInternal mammary sentinel lymph node biopsy with modified injection technique
Author(s) -
Bin Zhao,
Weiguang Zheng,
Heng Qiu,
Peng Chen,
Pengfei Qiu,
Yongsheng Wang
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000009466
Subject(s) - medicine , sentinel lymph node , breast cancer , axilla , biopsy , lymph , sentinel node , axillary lymph nodes , radiology , lymph node , cancer , pathology
Rationale: In addition to axillary lymph node (ALN), internal mammary lymph node (IMLN) is also the first-echelon drainage nodes reached by metastasising cancer cells from breast cancer, which can provide important prognostic information. Patient concerns: In this paper, we will introduce a case of breast cancer patient whose postoperative pathology result showed that she had internal mammary sentinel lymph node (IMSLN) metastases but no axillary sentinel lymph node (ASLN) metastases. Diagnoses: She was diagnosed as pT1cN1bM0 breast cancer based on the positive IMSLN but negative ASLN. Interventions: She received axillary-sentinel lymph node biopsy (A-SLNB) and internal mammary-sentinel lymph node biopsy (IM-SLNB) guided by modified injection technique. In the choice of chemotherapy, she received dose-dense AC × 4 times followed P × 4 times for chemotherapy. As to irradiation therapy, she received irradiation therapy include chest wall, superclavicular region, and internal mammary nodes. Outcomes: After performing IM-SLNB, the nodal staging of this patient increased (from N0 to N1b). And she received additional chemotherapy and irradiation therapy. Lessons: With the guidance of modified injection technique, the preoperative visualization rate of IMLN has been improved. IM-SLNB could be a minimally invasive technique for effective evaluation of the status of IMLN to provide information for staging and guide the adjuvant treatment.