BACKGROUND: The management of internal mammary nodes (IMNs) during multidisciplinary treatment of breast cancer has been debated for the last four decades without unequivocal conclusion. PATIENTS AND METHODS: We retrospectively reviewed patients with breast cancer who underwent sentinel lymph node biopsy at our center from 2008 until 2012. IMN drainage was assessed as a potential risk factor for local and distant disease recurrence. RESULTS: We identified 712 patients, with incidence of drainage to IMNs of 18.4%. No detrimental effect of the pattern of drainage to IMNs was found after a median follow-up of 58 months. A similar outcome was observed when drainage to IMNs was evaluated as a risk factor for patient survival. The potential risk factors for drainage to IMNs during sentinel lymph node biopsy were younger age (p=0.002) and tumor location in lower-outer, lower-inner, and upper-inner versus upper-outer quadrant (p<0.0001). CONCLUSION: The drainage to IMNs is unlikely to have a detrimental effect on patient outcome.

Department of Clinical and Molecular Pathology Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Nuclear Medicine Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Oncology Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Surgery 1 Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Department of Surgery Atlas Hospital Zlín Czech Republic

Faculty of Humanities Tomas Bata University in Zlín Zlin Czech Republic

Institute of Molecular and Translational Medicine Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic

Toxicogenomics Unit National Institute of Public Health Prague Czech Republic

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Internal mammary lymph node management - further direction