My mother has had a mastectomy following the recurrence of breast cancer (she had lymph nodes removed at that point, 13 years ago). They have found two enlarged internal mammary lymph nodes this time. What are the chances that they are cancerous, and what would that mean if they were?
Dear Tochter: Lymphatic tissue from the breast can drain into both the axillary (underarm) lymph nodes as well as the internal mammary lymph nodes. Routine surgical staging for invasive breast cancer usually involves a sampling of the axillary lymph nodes, but internal mammary lymph node sampling is less frequently done. A CT scan may be helpful for evaluating internal mammary lymph nodes and the size of the lymph nodes, along with the rest of the clinical information may help to determine the likelihood that they are involved. A variety of factors including the size and location of the recurrence, whether there is any distant recurrence and the hormone receptor status of the recurrence will influence magagement. Consultation with both a medical oncologist and a radiation oncologist may be appropriate.
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