title: [Internal mammary sentinel lymph node biopsy in breast cancer: accurate staging and individualized treatment].
abstract: OBJECTIVE
  The aim of this study was to determine the impact of routinely performed internal mammary sentinel lymph node biopsy (IM-SLNB) on the staging and treatment, and to analyze the success rate, complications and learning curve.
  
  
  METHODS
  All patients with biopsy-proven breast cancer who underwent sentinel lymph node biopsy between 2012 and 2014 were included in a prospective analysis. Internal mammary sentinel lymph node biopsy (IM-SLNB) was performed in all patients with IM-SLN visualized on preoperative lymphoscintigraphy and/or detected by intraoperative gamma probe detection. The adjuvant treatment plan was adjusted according to the current guidelines.
  
  
  RESULTS
  In a total of 349 patients, 249 patients (71.1%) showed internal mammary drainage. IM-SLNB was performed in 153 patients with internal mammary drainage, with a success rate of IM-SLNB of 97.4% (149/153). Pleural lesion and internal mammary artery bleeding were found in 7.2% and 5.2% patients, respectively. In 8.1% of patients (12/149) the IM-SLN was tumor positive. In the group of patients who underwent IM-SLNB, lymph node staging was changed in 8.1% of patients, and IMLNs radiotherapy was guided by these results, however, systemic treatment was changed in only 0.7% of the patients.
  
  
  CONCLUSIONS
  IM-SLNB has a high successful rate and good safety. Identification of internal mammary metastases through IM-SLNB may provide more accurate staging and guide the tailored internal mammary radiotherapy.
  
  
  BACKGROUND
  ClinicalTrials. gov, NCT01642511.
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Pengfe
authors.initials: P
authors.lastname: Qiu
authors.affiliation: Department of Medicine, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Rongrong
authors.initials: R
authors.lastname: Zhao
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Binbin
authors.initials: B
authors.lastname: Cong
authors.affiliation: Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Guoren
authors.initials: G
authors.lastname: Yang
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Yanbing
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Chen
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Sun
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Chunjian
authors.initials: C
authors.lastname: Wang
authors.affiliation: Breast Cancer Center, Shandong Cancer Hospital and Institute, Jinan, 250117, China.
authors.forename: Yongsheng
authors.initials: Y
authors.lastname: Wang
mesh_terms: D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D059032:Learning Curve; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008323:Mammary Arteries; D009367:Neoplasm Staging / Q000379:methods; D016609:Neoplasms, Second Primary; D011446:Prospective Studies; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*