Breast cancer. Current use of the extra-pleural exploration of the internal mammary chain
DOI:
https://doi.org/10.31053/1853.0605.v62.n2.27897Keywords:
.Abstract
The interest to know the lnternal Marnmary Chain (IMC) Involvement is that it is a lyrnphatic filter as primary as the axilla. Anatomic-surgical fundamcnts, were presented for thcir exploration .Fifty (50) pectus-sternal, analizing the number of nodes (average 9,7 per pecirnen), located preferably in the three first intercostals spaces, were studied. In the second phase IMC with a staging criterion and extrapleural way, resecting 1 or 2 costal cartilages, were explored. In 78 patients, pathological-anatomy correlation between IMC and the axilla, we observed 6% positive IMC with negative axilla. More recently in the era of the sentinel node, we have explored IMC in 44 patients through intercostal spaces and without cartilages resection. lo 28 patients we performed through radioisotopic way and gamma probe and in the remaining 16, through anatomic search !f the tumor was either upper mid or lower. The most frequent spaces explored were in the 2- and 3: 2.27 nodes average per patient. The pathological-anatomy between IMC and the axilla revealed the foliowing results: axilla (-) IM (-): 59%; axilla (+) MI (-): 25%; axilla (+) IM (+): 11% and axilla (-)IM (+): 5%. Wc concluded that this is a non - aggressivc method, with an exccllent tolerance that aliows the evaluation of another filter as primary as the axilla aoci that together they represent the hest systemic disease prognostics. We believe that its exploration is justified in those cases in which the histological result , correlated with the axilla, aliows a therapeutic approach change.
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