Intramammary Lymph Node involvement

cabmom

Hi all!  Has anyone else out there had an intramammary lymph node involvement in the breast but not axillary lymph node involvement under the arm?  If so, how was your case handled?  This particular issue has caused me to have multiple answers and treatments suggested so just not sure what to believe or what to do.  Can anyone share their experiences?

Brenda_R

I had a positive internal mammary node at dx. The only reason I even knew it was because it showed on a pet/ct scan and a subsequent ct scan.  It couldn't be surgicaly removed (under the breastbone), so I was treated with chemo and radiation, with the last week being targeted to that area.  I had no positive axillary nodes.

My cancer was in the inner portion of my breast. 

I am now almost 3 years from dx and 1 &1/2 years out from active treatment. 

Because I'm her2 positive, I was on Herceptin for a year after chemo and rads.

Lisa_S

cabmom, I'm wondering what you decided to do.  I was diagnosed in October, and just had my lumpectomy last week (11/20).  My situation sounds very similar to yours.  I had a 1cm tumor (IDC ER+, PR+, HER2-) and an intramammary lymph node (both removed during surgery).  My sentinel node came back negative during surgery (which was an unexpected surprise), although we're waiting on the final pathology to confirm this.  Assuming the sentinel node remains negative, my oncologist is recommending oncotype dx testing to determine whether I should have chemo.  What did you decide to do?  And why?

cabmom

Lisa_S, sorry it's taken me so long to get back to you but I did decide on chemo and have almost completed it.  Having a intraammary lymph node certainly made my decision more difficult because my axillary came back negative as well.  My surgeon would not agree to just do a sentinel node on me because they was not sure that the intramammary had not messed up the normal passage on the lymph system but congrats on yours coming back clean as well....that is great.  I decided on chemo for added insurance on getting everything just is case something might have passed through.  My onco score was 19.......again sorry it took me so long to get back to you.

pamgroth

How are you doing? I'm just starting the process with the IMN

Diagnosis. I had a double mastectomy 2 yrs ago.

cabmom

pamgroth, I'm doing great and I hope you are as well.  I'm a little over 1 year out from chemo and end of April, I'll be one year out from radiation.  Still on Tamoxifen and tolerating it okay.

pamgroth

I'm having the 2 internal mammary nodes in question biopsied this Monday. I will start AC chemo April 6th 4x/2 weeks and then Taxol 4x/2 weeks after receiving the biopsy report. My original BC biopsy was ER+ PR- HER2 -. I've been on Arimidex for the last 2 years and I am BRCA 1. Pending biopsy report the Arimidex could change.

Do you find it difficult to find information on the internal mammary lymph nodes?

cabmom

pamgroth, yes....it was very hard to find information on the inter-mammary lymph nodes.  Even the doctors were not very open to discussing their involvement to much.  I hope you've been able to gather enough information.  Good luck with your treatments!

jacee

Pamgroth- Are you and cabmom referring to the same thing? She is talking about intramammary nodes which are lymph nodes within breast tissue. You are talking about internal mammary nodes which are along the sternum and inbetween the ribs.

I'm finding these often get confused on these threads. I had an internal mammary node as a sentinel node so I've tried to find all I can to read about it.....would love to hear which nodes you ladies had positive to compare.....Joni

cabmom

hey jacee....I am talking about the intramammary lymph nodes that are within the breast tissue and I was very lucky because when they took all my axillary lymph nodes they were all negative.  I considered myself to be very blessed, as did my surgeon.  She honestly thought that they would all be affected.  Thanks for the clarification because I didn't realize that Pamgroth and I were discussing two different things. 

jacee

Sorry you had to  have so many nodes removed, but I know you were thrilled to find the axillary nodes all negative!!

I had an axillary sentinel node and an intermal mammary sentinel node. Both were positive and removed. Then with axillary node disection one more node came back positive. Did chemo, rads, bilateral DIEP recon and now on femara. It's good to feel the life coming back!

cabmom

jacee, thanks and yes, I was very relieved that they were negative but I'm already a stage 1 lymphodema but it's under control so for that I am also grateful.  Seems that it's a never ending journey but I have to tell you that I am also finally feeling somewhat normal again.....that is a very good feeling.

Sorry that you had positive nodes but I am very happy to hear that you are also feeling back to normal again.  This is definitely a journey that I know all of us wish we didn't have to make.... 

Beth-In-Tenn

Hi ladies,

I'm newly diagnosed (just had a bi-lateral mastectomy), and about to start chemo in a couple of weeks.  My path report showed two additional tumors in addition to the main one which was 3 cm (and never showed up on mammography) as well as an intramammary lymph node (IMLN) which was "involved by metastatic mammary carcinoma" - and was 4 mm in size.  I too have had trouble finding additional information on the IMLN as it seems there isn't much current research out there (and some of it conflicting).  My Oncotype DX score was 40 so we knew it was a "high risk" cancer and the additional newly discovered growths told my MO is was also "very aggressive."

Wondering how you are each doing and if you learned more about IMLNs that you would be willing to share?