title: A positive intramammary lymph node does not mandate a complete axillary node dissection.
abstract: BACKGROUND
  We hypothesized that even in the face of a positive intramammary lymph node (IMLN) a negative axillary sentinel lymph node (SLN) reliably stages the axilla and complete axillary lymph node dissection (CALND) can be avoided.
  
  
  METHODS
  A literature search identified 386 publications that included IMLNs and SLN biopsies. Patients with a positive IMLN and negative axillary SLN who underwent a CALND were included. A review of our database was also performed.
  
  
  RESULTS
  Twenty-one cases in the literature met our criteria. A review of our database resulted in 2 additional cases. Twenty-three patients were identified who had a positive IMLN, negative axillary SLN biopsy, and underwent a CALND. In all cases, the CALND was negative.
  
  
  CONCLUSIONS
  An axillary SLN biopsy accurately represents the disease status of the axilla in cases with a positive IMLN. CALND can be avoided in the setting of a positive IMLN and a negative axillary SLN biopsy.
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Diaz
authors.forename: Amy C
authors.initials: AC
authors.lastname: Degnim
authors.forename: Judy C
authors.initials: JC
authors.lastname: Boughey
authors.forename: Aziza
authors.initials: A
authors.lastname: Nassar
authors.forename: James W
authors.initials: JW
authors.lastname: Jakub
mesh_terms: D001365:Axilla; D001940:Breast; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D019564:Unnecessary Procedures