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Objective: The clinical meaning of intramammary lymph nodes (iMLNs) is uncertain. We wanted to describe the clinical characteristics and understand the implications of iMLNs detected by sentinel LN biopsy (SLNB). Methods: We reviewed the clinical, radiological and pathological records of women diagnosed with invasive carcinoma of the breast at the Samsung Medical Center between January 2001 and January 2011. A total of 69 patients were identified, and SLNB was performed in 31 patients. Results: Of the 69 patients included in the study, 22 (31.9%) had metastases in iMLNs. The presence of lymphovascular invasion and the number of axillary LN metastases were associated with iMLN metastasis. Of the 31 patients who underwent SLNB, there were no cases with axillary LN metastasis when axillary SLNB was negative, even in cases of iMLN-positive patients. Of the 10 patients in whom intramammary SLNs (iMSLNs) were detected during SLNB, 8 patients without iMLN metastases were also negative for axillary LNs. Conclusion: Patients with metastatic iMLNs had more aggressive cancers with lymphovascular invasion and increased axillary LN metastases. When iMSLN was detected by SLNB, performing of axillary dissection could be determined by the status of the iMSLN itself. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objectives: This study was designed to assess the necessity of delayed complete axillary lymph node dissection (cALND) for patients whose sentinel lymph nodes (SLNs) were negative for tumors on intraoperative frozen section analysis, but later proven positive on hematoxylin and eosin staining or immunohistochemistry. Methods: We identified 341 patients who underwent sentinel lymph node biopsy (SLNB) with cALND at the Samsung Medical Center between 1998 and 2008, and reviewed the clinicopathological records of women diagnosed with invasive carcinoma of the breast. Results: Of the 341 patients, 59 underwent delayed cALND due to negative results on frozen section. Only 1 patient had a non-SLNs metastasis in the group of delayed cALND. Delayed cALND was associated with higher rates of breast-conserving surgery, smaller primary tumor and metastasis size in SLNs, fewer metastatic lymph nodes and SLNs and a lower TNM stage. The detection of metastases of SLNs on frozen section and the number of metastatic SLNs were related to the detection of additional metastases of nonsentinel lymph nodes (NSLNs) in cALND. Conclusion: Our findings suggest that the lack of detection of metastases on frozen sections may be a predictive factor for nonmetastasis in NSLNs. cALND could therefore be omitted in such cases. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]