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De Alcantara Filho et al. J Cancer Metastasis Treat 2019;5:2 Journal of Cancer
DOI: 10.20517/2394-4722.2018.62 Metastasis and Treatment

Case Report Open Access

Axillary recurrence after intramammary sentinel
lymph nodes metastases with capsular extravasation

Paulo R. De Alcantara Filho , Stephania Martins Bezerra 2
1
1 Breast Surgery Department, Hospital Sirio-Libanes, Sao Paulo 01308-050, Brazil.
2 Pathology Department, ACCamargo Cancer Center, Sao Paulo 01509-010, Brazil.
Correspondence to: Dr. Paulo R. De Alcantara Filho, Breast Surgery Department, Hospital Sirio-Libanes, RUA DONA ADMA
JAFET 74, Sao Paulo 01308-050, Brazil. E-mail: institutodemastologia@gmail.com
How to cite this article: De Alcantara Filho PR, Bezerra SM. Axillary recurrence after intramammary sentinel lymph nodes
metastases with capsular extravasation. J Cancer Metastasis Treat 2019;5:2. http://dx.doi.org/10.20517/2394-4722.2018.62

Received: 18 Sep 2018 First Decision: 5 Dec 2018 Revised: 14 Dec 2018 Accepted: 25 Dec 2018 Published: 14 Jan 2019

Science Editor: William Schiemann Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Axillary recurrence is a rare event in patients treated with sentinel lymph node biopsy alone with the majority
occurring in the first 5 years after surgery. Intramammary lymph node (IMLN) can be the primary sites of
metastasis and sentinel lymph nodes, but the clinical significance, including prognosis and therapeutic approach is
yet unclear, even more with capsular extravasation. IMLN metastases are strongly correlated with axillary lymph
nodes involvement and therefore a guide for further surgical management of the axillary nodes.

Keywords: Breast cancer, sentinel lymph node, lymph node dissection, metastasis, locoregional neoplasm
recurrence

INTRODUCTION
Reported series of patients with intramammary lymph node (IMLN) diagnosed by final histological
[1]
examination are small in number and clinical significance of metastasis is still unclear . We previously
reported a case of conservative breast cancer surgery with 3 positive IMLNs demonstrating extracapsular
extravasation (ECE). After multidisciplinary discussion, the patient was submitted to mastectomy and no
further axillary dissection. Even though the 3 IMLNs were positive, pathology examination did not reveal
any signs of malignancy in the mastectomy specimen. The patient underwent adjuvant chemotherapy,
[2]
radiation and endocrine therapy . Here we report the new event after 2 years of follow up.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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