Breast Cancer with Internal Mammary Node Metastases: A Case Presented in a Tumor Board Session and decision making

Background: There are several therapeutic options available for breast cancertreatment, now incorporating innovative targeted molecular therapies. Metastaticbreast cancer is usually treated with chemotherapy and/or hormonotherapy.Surgery has not been shown to improve survival. Adjuvant radiotherapy (RT) hasbeen proven to be effective in the treatment of locally advanced breast cancer,reducing locoregional recurrence. The optimal treatment of internal mammarylymph nodes (IMN) metastases remains controversial.Case presentation: A ۴۸-year-old woman was diagnosed with invasive breastcancer with ipsilateral metastases to axillary lymph nodes and a contralateral IMNmetastasis. This case was presented twice during the tumor board sessions of theSurgical Oncology Service at the Centre hospitalier de l'Université de Montréal(CHUM), Montréal, Canada. Question: Does the internal mammary chain (IMC) dissection could be used asKey words: a treatment approach in breast cancer with IMC metastasis? Conclusion: Internal mammary chain dissection should be discussed in tumorboard sessions on a case-by-case basis. There are no strong guidelines on themanagement of IMN metastasis in breast cancer, but there is growing evidence thatthese women should be treated with curative intent.

Keywords:

Breast cancer , internal mammary node metastasis , lymph nodes dissection , radiotherapy , tumor board