Internal mammary node abnormality in imaging studies and treatment outcomes in patients with breast cancer

Makita,Kenji; Hamamoto,Yasushi; Kanzaki,Hiromitsu; Nagasaki,Kei; Aogi,Kenjiro

doi:10.3892/ol.2024.14352

Internal mammary node abnormality in imaging studies and treatment outcomes in patients with breast cancer

Authors:
- Kenji Makita
- Yasushi Hamamoto
- Hiromitsu Kanzaki
- Kei Nagasaki
- Kenjiro Aogi
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Affiliations: Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan, Department of Breast Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791‑0280, Japan
Published online on: March 21, 2024 https://doi.org/10.3892/ol.2024.14352
Article Number: 218
Copyright: © Makita et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY_NC 4.0].

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Abstract

The clinical significance of mild internal mammary node (IMN) enlargement (Mild‑IMN) is uncertain. This study aimed to evaluate the relationship between treatment outcomes and IMN status in patients with breast cancer who underwent postmastectomy radiation therapy between January 2010 and December 2018. Overall, 250 patients were categorized based on IMN status: Clinically normal IMN (Normal‑IMN; n=172), Mild‑IMN (n=39) and clinically metastatic IMN (cMet‑IMN; n=39). None of the patients in the Normal‑ or Mild‑IMN groups received IMN irradiation. In the cMet‑IMN group, 25 patients underwent IMN irradiation with an IMN boost (10 Gy in 5 fractions), while 14 patients did not. The median follow‑up time was 80.0 months (range, 7.2‑147.6 months). The 7‑year overall survival (OS), disease‑free survival (DFS) and IMN recurrence‑free survival (IRF) rates were 80.2, 73.0 and 93.4%, respectively. Multivariate analyses indicated that only cMet‑IMN had a significant impact on OS [hazard ratio (HR), 1.66; 95% CI, 1.01‑3.68; P=0.05] and DFS (HR, 1.91; 95% CI, 1.08‑3.39; P=0.03), while cMet‑IMN did not have a significant impact on IRF (HR, 1.66; 95% CI, 0.41‑6.78; P=0.48). Additionally, receiving an IMN boost had no influence on OS (HR, 1.11; 95% CI, 0.37‑2.34; P=0.84), DFS (HR, 1.28; 95% CI, 0.51‑3.22; P=0.60) or IRF (HR, 1.94; 95% CI, 0.22‑17.47; P=0.55). In conclusion, the impact of Mild‑IMN on clinical outcomes was small. Although irradiation for cMet‑IMN is important, the impact of the cMet‑IMN boost with 10 Gy in 5 fractions on clinical outcomes may also be limited.

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