79 y/o F presents for diagnostic MRI for extent of disease. What is notable on the imaging shown?
INTERNAL MAMMARY LYMPHADENOPATHY
Metastases to the internal mammary nodes usually occur after a tumor has metastasized to the axilla
Nodal staging is considered N3b (stage IIIC disease)
Isolated metastases to the internal mammary nodes occur in 1%–5% of breast cancers and usually come from deep or medial lesions
In the absence of axillary metastases, involvement of the internal mammary nodes constitutes N2 disease
No survival benefit to surgical treatment of internal mammary node metastases, and because of the morbidity, dissection of the nodes is not usually performed
Radiation treatment planning may be altered if metastases of the internal mammary nodes are identified