Significance of internal mammary lymph nodes in patients after mastectomy with tissue-expander reconstruction: a case–control study

Kaewlai, R.; Digumarthy, S.R.; Smith, B.L.; Corben, A.D.; Austen, W.G.; Shepard, J.-A.O.; Sharma, A.

doi:10.1016/j.crad.2010.01.015

« Previous Next »Clinical Radiology
Volume 65, Issue 6 , Pages 453-459, June 2010

Significance of internal mammary lymph nodes in patients after mastectomy with tissue-expander reconstruction: a case–control study

R. Kaewlai
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Guarantor and correspondent: R. Kaewlai, Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, FND-210, Boston, MA 02114, USA. Tel.: +1 617 724 5246; fax: +1 617 726 3077.
S.R. Digumarthy
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
B.L. Smith
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
A.D. Corben
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Current address: Department of Pathology, Memorial Sloan Kettering Cancer Center Breast and Imaging Center 300 East 66th Street, New York, NY 10065, USA.
W.G. Austen Jr.
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
J.-A.O. Shepard
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
A. Sharma
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

Received 30 September 2009; received in revised form 10 January 2010; accepted 14 January 2010. published online 05 April 2010.

Aim

To retrospectively assess the frequency of internal mammary lymph nodes (IMNs) in patients after mastectomy and tissue-expander reconstruction.

Materials and methods

Statistical analysis was performed for all available data in patients with mastectomy and tissue-expander reconstruction from 2004–2007 (study group). The data were compared with that of a control population with mastectomy who did not have reconstruction (control group). Patients with recurrent breast cancers, previous breast reconstruction, surgeries performed at outside hospitals, no available pre- or postoperative computed tomography (CT) or magnetic resonance imaging (MRI) data, or inadequate imaging follow-up were excluded.

Results

There were eight patients in the study group (median age 50.5 years, seven breast cancers), and eight patients in the control group (median age 52 years, seven breast cancers). No patients had IMNs on their preoperative imaging examinations. New IMNs were present in postoperative imaging in seven of eight patients (7/8, 87.5%) in the study group. All of them were stable or decreased in size on subsequent imaging examinations. None of the patients in the control group had IMNs (0/8).

Conclusion

IMNs are common on imaging after mastectomy and tissue-expander placement. The IMNs decreased or remained stable on follow-up imaging and may represent reactive nodes.