What is internal mammary lymph nodes?

The internal mammary lymph node (IMLN) chain is a pathway through which breast lymphatic drainage flows. The internal mammary lymphatic vessel runs around the internal mammary artery and veins with IMLN in the parasternal intercostal spaces.

Can MRI detect breast cancer in lymph nodes?

Magnetic resonance imaging (MRI) can evaluate the breasts and breast cancer related areas such as axillary lymph nodes, skin or pectoral muscle that are important for prognosis.

Can internal mammary lymph nodes be removed?

However, till now, there is no an ideal method to detect out metastatic nodes in internal mammary lymph chain exactly. Thoracoscopic internal mammary lymph chain dissection has been reported, but it is difficult to remove the left internal mammary nodes by this technique.

Are internal mammary lymph nodes palpable?

Because the internal mammary lymph nodes are non-palpable on clinical exam, the rate of IMN recurrence may be underreported.

How many internal mammary lymph nodes are there?

Of the 68 internal mammary lymph nodes, 32 (47%) were seen in the second intercostal space, and 31 (46%) were seen in the third intercostal space.

Where do internal mammary lymph nodes drain to?

Lymphatic drainage of breast originates from breast lobules and flows through intramammary nodes and channels into a subareolar plexus, called Sappey’s plexus.

Where is the internal mammary lymph node located?

Internal mammary lymph nodes are more commonly seen on the left side, in the second or third intercostal space, and medial to the internal mammary blood vessels (5,6).

What is a normal size intramammary lymph node?

Normal IMLN are typically described in all imaging exams as a circumscribed mass, smaller than 10 mm, with oval or reniform shape and hilar fat, usually at a peripheral location, adjacent to a vein (Figure 1).

What are Rotter’s nodes?

Interpectoral lymph nodes, also known as Rotter lymph nodes, are located in the interpectoral fascia in Rotter space, between the pectoralis major and pectoralis minor muscles. Their number varies from one to four. They are usually considered to be a separate nodal group from the level I and II axillary nodes.

Where do internal mammary lymph nodes drain?

IT nodal afferent lymphatic flow is received from the retromammary lymphatics, anterior chest wall, and structures of the upper anterior abdomen. Efferent lymphatics drain into the venous system via the right lymphatic duct, thoracic duct, and inferior deep cervical nodes (2,8).

How are internal mammary lymph nodes visualized on MRI?

It is important to identify the characteristics of nonmetastatic physiologic internal mammary lymph nodes. Internal mammary lymph nodes detected on breast MRI examinations at the time of a new cancer diagnosis can alter the breast cancer staging if metastasis to an internal mammary lymph node is suspected.

How big can internal mammary lymph nodes be?

Internal mammary lymph nodes measuring up to 10 mm are commonly seen on high-risk screening breast MRI examinations in patients without breast cancer and are considered benign if no other suspicious findings are present.

Can a MRI detect lymphadenopathy in breast cancer?

MRI of Internal Mammary lymph nodes can detect lymphadenopathy in breast cancer patients, which implies a higher cancer stage and worse prognosis for the patient.

Are there incidental lymph nodes in the breast?

Incidental internal mammary lymph nodes, found in 46% of women in our study, are a relatively common finding in women presenting for high-risk screening MRI. The axilla and internal mammary lymph nodes comprise the primary lymphatic drainage of the breast.