Management of Intramammary Lymph Nodes in Breast Cancer

Diagnostic Evaluation and Management

• The American Joint Committee on Cancer recommends that positive IMLNs should be counted as positive lymph nodes in the N staging, which may affect the overall stage and subsequent treatment decisions 3, 4, 5
• If axillary SLN is positive, complete axillary lymph node dissection should be performed, and consider regional nodal irradiation based on the extent of nodal involvement 1
• For patients with positive IMLNs and positive axillary nodes, consider regional nodal irradiation including the supraclavicular region if 4 or more nodes are positive 2