Lymph nodes in the human female breast: A review of their detection and significance

Our experience led us to test the hypothesis that lymph nodes are nor uncom mon within the substance of the human female breast mound. The following sp ecimen types and sources were used to survey the presence of intramammary l ymph nodes in the human female breast mound: (1) cadaver breasts; (2) commu nity hospital breast specimens; and (3) university and VA hospital specimen s. We found true lymph nodes within and associated with breast specific tis sue (ie, tissue that includes duct and gland structures), thereby validatin g the hypothesis posed. We discuss the significance of these findings in te rms of our dominant patient care paradigm (the Triple Test-physical examina tion, imaging, and fine-needle aspiration [FNA]) and the choice of patient care management options. We conclude the following: lymph nodes occur in an y quadrant of the breast mound; recognizing the possibility of intramammary lymph nodes is important when choosing between patient management options; intramammary lymph nodes can be sampled by FNA; intramammary lymph nodes c an contain various disease processes; and in the Oregon Health Sciences Uni versity Multidisciplinary Breast Clinic, these intramammary lymph nodes are commonly identified by imaging methods and are more likely to be sampled b y FNA than either by core or excisional biopsy. HUM PATHOL 32:178-187. Copy right (C) 2001 by W.B. Saunders Company.