1. The value of radiotherapy on metastatic internal mammary nodes in breast cancer. Results on a large series
- Author
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Umberto Veronesi, Andrea Sagona, Paolo Veronesi, Roberto Orecchia, Paolo Arnone, M.C. Leonardi, Giovanni Ivaldi, Giovanni Paganelli, Viviana Galimberti, R. Panzeri, Giuseppe Viale, N. Rotmensz, Edoardo Botteri, and Alberto Luini
- Subjects
Oncology ,Cancer Research ,Mastectomy, Segmental ,Metastasis ,Cohort Studies ,Breast cancer ,Internal Mammary Lymph Node ,Lymph node ,Aged, 80 and over ,Hematology ,Middle Aged ,Internal mammary nodes ,Treatment Outcome ,medicine.anatomical_structure ,Evaluation Studies as Topic ,Lymphatic Metastasis ,Female ,Breast disease ,Breast carcinoma ,Axillary lymph nodes ,Adult ,medicine.medical_specialty ,education ,Breast Neoplasms ,Risk Assessment ,Disease-Free Survival ,NO ,Internal medicine ,medicine ,Humans ,Mammary Arteries ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Carcinoma ,Dose-Response Relationship, Radiation ,medicine.disease ,Survival Analysis ,Logistic Models ,Axilla ,Multivariate Analysis ,Lymph Node Excision ,Radiotherapy, Adjuvant ,Lymph Nodes ,business ,Follow-Up Studies ,Gamma probe - Abstract
The 'regional nodal mapping', is a fundamental step to stage breast carcinoma. In addition to the axillary nodes status, the involvement of internal mammary nodes is an important prognostic factor. Six hundred and sixty-three patients with breast carcinoma, mainly in the inner quadrants, underwent a biopsy of internal mammary nodes. Positive internal mammary nodes were found in 68 out of 663 cases (10.3%) representing 27.2% of all cases with regional node metastases (250). When histologically proven metastases were detected, radiotherapy was administered to the internal mammary nodes chain. In 254 cases, the surgeon's exploration was guided by a gamma probe. Out of these cases, 28 (11.0%) showed metastatic involvement. Out of the other 409 cases, not radioguided, 40 showed positive nodes (9.8%). Patients with internal mammary metastases treated with radiotherapy and appropriate systemic treatment showed an excellent survival (95% at 5 years), a result which is in opposition to the previous experience, which stated that invasion of internal mammary nodes is an ominous prognostic sign. We assume that this excellent result is due to radiotherapy to internal mammary nodes and we propose that exploration of internal mammary nodes should be part of the staging process of carcinomas of the medial part of the breast.
- Published
- 2008
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