Abstract
Knowledge of lymphatic system anatomy allowed development of SLN procedure (SLN) in breast cancer then lymph anatomy and function were both enriched. Particularly, internal mammary chain (IMC) drainage is now well known. However, it is still discussed how IMC status could impact prognostic and then therapeutic guidelines. First, we will present facts and controversies about IMC in breast cancer. In a second part, we will describe Grenoble experience about 3 consecutives studies with patients included between 2002 and 2012, receiving SLN procedure including peritumoral injection and then biopsies of identified axillary and also IMC SLNs. We observed 28% of IMC drainage, allowing an identification of IMC involvement in 3% of all patients. IMC SLN biopsy, once well controlled, is safe, with less than 5% of minor complications. IMC status induced major treatment modifications in 1% of procedures. Likewise, irradiation modalities will be improved by IMC status information.
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