Ann Surg Treat Res.  2017 May;92(5):376-379. 10.4174/astr.2017.92.5.376.

Intramammary sentinel lymph node with capsular extravasation in breast cancer

• De Alcantara Filho PR
• Curi C
• Guatelli C
• Osorio CA
• Bezerra SM
• Soares FA
• Makdissi F

• KMID: 2377710
• DOI: http://doi.org/10.4174/astr.2017.92.5.376

Abstract

Sentinel lymph node biopsy has been developed as the standard of treatment in breast cancer. Status of axillary sentinel lymph node is known to be a significant prognostic factor. Nevertheless, involvement of an intramammary lymph node with metastasis in breast cancer is a rare radiological and clinical presentation, and with extracapsular extravasation even more uncommon. Historically, reported series of patients with intramammary lymph node diagnosed by final histological examination are small in number and clinical significance of metastasis is still unclear. Here, we report a case of conservative breast cancer surgery with 3 intramammary sentinel lymph nodes containing metastasis and extracapsular extravasation. After multidisciplinary consensus, the patient was surgically reapproached with mastectomy. Even though the 3 intramammary sentinel lymph nodes were positive for metastases, pathology examination did not reveal any signs of malignancy in the mastectomy specimen.

Keyword

Breast neoplasms; Lymph nodes; Neoplasm invasiveness; Lymphatic metastasis; Sentinel lymph node biopsy

MeSH Terms

Breast Neoplasms*
Breast*
Consensus
Humans
Lymph Nodes*
Lymphatic Metastasis
Mastectomy
Neoplasm Invasiveness
Neoplasm Metastasis
Pathology
Sentinel Lymph Node Biopsy

Figure

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  Fig. 1 (A) Postcontrast sagital T1-weighted magnetic resonance images of the right breast shows an irregular mass with spiculated margins and heterogeneous enhancement located in the junction of the outer quadrants, compatible with the primary tumor. (B) Small round mass with circumscribed margins and with homogeneous enhancement located in the posterior aspect of the lower inner quadrant, near the chest wall, which corresponded to a suspicious intramammary lymph node.

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  Fig. 2 (A) Panoramic image of the intramammary lymph node dissected, all affected by breast cancer metastasis (H&E, staining, ×40). (B) High-power view (H&E, ×100) of the extracapsular extension of the carcinoma in the adipose tissue.

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