Tumor Contact With Internal Mammary Perforator Vessels as Risk Factor for Gross Internal Mammary Lymph Node Involvement in Patients With Breast Cancer

The Role of MRI in Breast Cancer and Breast Conservation Therapy

“…Invasion into the nipple-areolar complex [66] Presence of a MRI incompatible implantable device Multicentric/multifocal disease [68] Mammographically occult disease in contralateral breast [17,[69][70][71][72][73][74] Metastatic involvement of axillary or IMN nodes [36,52,[77][78][79]91,96,97] Tumor response to NAT [57][58][59]70,[120][121][122][123][127][128][129][130] Post treatment changes in the breast Non-ionizing radiation The normal appearance of the breast following partial mastectomy often includes a seroma at the surgical site (Figure 11). Seromas and surgical cavities containing fluid will demonstrate increased T2/STIR signal and be most conspicuous on a fluid-sensitive sequence (Figure 11A).…”

“…High sensitivity [5][6][7][8][9][10] Cost Tumor size estimation [55][56][57][58][59] Accessibility Defining extent of disease Claustophobia Pectoralis major/minor invasion [64,65] IV gadolinium contrast allergy (rare) Invasion into the nipple-areolar complex [66] Presence of a MRI incompatible implantable device Multicentric/multifocal disease [68] Mammographically occult disease in contralateral breast [17,[69][70][71][72][73][74]] Metastatic involvement of axillary or IMN nodes [36,52,[77][78][79]91,96,97] Tumor response to NAT [57][58][59]70,[120][121][122][123][127][128][129][130] Post treatment changes in the breast Non-ionizing radiation…”

“…Tumors with involved IMLNs are characteristically associated with a deep or medial lesion [ 36 , 90 ]. A retrospective study showed that the MRI identification of tumor contact with an internal mammary perforator vessel had high accuracy in predicting ipsilateral and contralateral IMLN involvement [ 91 ]. As the surgical dissection of IMLN metastases has not shown a survival benefit, surgical treatment of IMLN metastases is not typically performed, particularly given the associated morbidity [ 90 ].…”