Metastatic intramammary lymph node as the only manifestation of breast carcinoma

Intramammary lymph nodes are detected in 5% of screening mammographies. Sufficient grounds for histological examination to exclude malignancy are the absence of the hilar fatty radiolucent notch, a reduction in the volume of the central echogenic hilum, size greater than 1 cm or an increase in size compared with previous screens. Despite advances in radiological screening and the widespread use of sentinel lymph node biopsy in the surgical treatment of early breast carcinoma, breast cancer metastasis to intramammary lymph nodes is usually an incidental finding during surgery or in subsequent histological examination. The surgical treatment of the axilla in cases of metastatic intramammary lymph nodes is currently controversial. Independently of the surgical management of the axilla and the presence or absence of metastatic axillary lymph node, a finding of a metastatic intramammary lymph node changes not only the patient's prognosis but also the approach to the use of adjuvant therapy. (C) 2011 Elsevier Espana, S.L. All rights reserved.