THE DIAGNOSIS OF INTERNAL MAMMARY NODE METASTASES OF BREAST-CANCER

It is important to know the status of internal mammary lymph node (IMN ) in estimating the prognosis in patients with breast cancer and/or pl anning the treatment. In the first series of this study, the diagnosti c value of internal mammary lymphoscintigraphy (IMLS) and that of para sternal sonography (PS) were evaluated in 57 patients. The overall dia gnostic accuracy of IMLS was 72% and that of PS, 84%, compared with IM N metastases confirmed on a biopsy. In the second series, 23 patients who underwent extended radical mastectomy and were found to have IMN m etastases, were examined for the sizes and locations of metastatic IMN . Minute metastatic lymph nodes not detectable by IMLS or PS were foun d in 9 (39%) of the patients. However, the incidence of metastases to the first and/or second intercostal spaces was 97% for the patients. W e concluded that a biopsy of the first and second intercostal spaces i s useful in providing the information of IMN status.