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Incidence and Potential Significance of Internal Mammary Lymphadenopathy on Computed Tomography in Patients with a Diagnosis of Primary Breast Cancer.

Savaridas SL, Spratt JD, Cox J - Breast Cancer (Auckl) (2015)

Bottom Line: However, 16% (25) had larger nodes, greater than 5 mm in short axis, present on CT.Significantly more patients with the presence of large (>5 mm) IMNs had more advanced disease with CT evidence of other distant spread.We suggest that further histological research is required to establish reliable CT size criterion for pathological IMNs.

View Article: PubMed Central - PubMed

Affiliation: University Hospital of North Durham, Durham, County Durham, UK. ; North Tyneside General Hospital, North Shields, Tyne-and-Wear, UK.

ABSTRACT

Introduction: The importance of internal mammary nodes (IMNs) in the staging and treatment of breast cancer patients is controversial.

Methods: A retrospective cohort of patients diagnosed with primary breast cancer over a 4-year period (January 2009 to December 2012) was assessed. The number and size of any IMNs visible on spiral computed tomography (CT) were recorded.

Results: A total of 830 patients were diagnosed with primary breast cancer within the identified time frame, of which 150 patients met the inclusion criteria. Of these 42% (63) had IMNs present, although the majority were small (<5 mm). However, 16% (25) had larger nodes, greater than 5 mm in short axis, present on CT. Significantly more patients with the presence of large (>5 mm) IMNs had more advanced disease with CT evidence of other distant spread.

Conclusion: We have demonstrated that IMNs are present in a substantial number of our primary breast cancer patients. We suggest that further histological research is required to establish reliable CT size criterion for pathological IMNs. In addition, routine imaging of the IM chain, as well as axilla, should be considered in the staging of breast cancer.

No MeSH data available.


Related in: MedlinePlus

Right IMN >10 mm in short axis in a patient with florid liver metastases.
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f1-bcbcr-9-2015-059: Right IMN >10 mm in short axis in a patient with florid liver metastases.

Mentions: The patient age within each group was similar, with means ranging from 60.77 to 62.63 years. The vast majority of CTs were performed as part of staging work-up, with a minority being CT pulmonary angiograms performed to exclude pulmonary emboli. Of the 149 patients included, 42% (62) had IMNs present, although the majority were small (<5 mm). However, 16% (25) had larger nodes greater than 5 mm present on CT. Of these, the IMNs were only commented on in the CT report in four cases. In one of these instances, the node present was greater than 10 mm in the short axis (Fig. 1). Comparison between patients with no IMNs present and IMNs of any size is displayed in Table 1. Table 2 demonstrates the comparison between patients with no IMNs and those with IMNs greater than 5 mm in the short axis.


Incidence and Potential Significance of Internal Mammary Lymphadenopathy on Computed Tomography in Patients with a Diagnosis of Primary Breast Cancer.

Savaridas SL, Spratt JD, Cox J - Breast Cancer (Auckl) (2015)

Right IMN >10 mm in short axis in a patient with florid liver metastases.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4525791&req=5

f1-bcbcr-9-2015-059: Right IMN >10 mm in short axis in a patient with florid liver metastases.
Mentions: The patient age within each group was similar, with means ranging from 60.77 to 62.63 years. The vast majority of CTs were performed as part of staging work-up, with a minority being CT pulmonary angiograms performed to exclude pulmonary emboli. Of the 149 patients included, 42% (62) had IMNs present, although the majority were small (<5 mm). However, 16% (25) had larger nodes greater than 5 mm present on CT. Of these, the IMNs were only commented on in the CT report in four cases. In one of these instances, the node present was greater than 10 mm in the short axis (Fig. 1). Comparison between patients with no IMNs present and IMNs of any size is displayed in Table 1. Table 2 demonstrates the comparison between patients with no IMNs and those with IMNs greater than 5 mm in the short axis.

Bottom Line: However, 16% (25) had larger nodes, greater than 5 mm in short axis, present on CT.Significantly more patients with the presence of large (>5 mm) IMNs had more advanced disease with CT evidence of other distant spread.We suggest that further histological research is required to establish reliable CT size criterion for pathological IMNs.

View Article: PubMed Central - PubMed

Affiliation: University Hospital of North Durham, Durham, County Durham, UK. ; North Tyneside General Hospital, North Shields, Tyne-and-Wear, UK.

ABSTRACT

Introduction: The importance of internal mammary nodes (IMNs) in the staging and treatment of breast cancer patients is controversial.

Methods: A retrospective cohort of patients diagnosed with primary breast cancer over a 4-year period (January 2009 to December 2012) was assessed. The number and size of any IMNs visible on spiral computed tomography (CT) were recorded.

Results: A total of 830 patients were diagnosed with primary breast cancer within the identified time frame, of which 150 patients met the inclusion criteria. Of these 42% (63) had IMNs present, although the majority were small (<5 mm). However, 16% (25) had larger nodes, greater than 5 mm in short axis, present on CT. Significantly more patients with the presence of large (>5 mm) IMNs had more advanced disease with CT evidence of other distant spread.

Conclusion: We have demonstrated that IMNs are present in a substantial number of our primary breast cancer patients. We suggest that further histological research is required to establish reliable CT size criterion for pathological IMNs. In addition, routine imaging of the IM chain, as well as axilla, should be considered in the staging of breast cancer.

No MeSH data available.


Related in: MedlinePlus