L'Asportazione Dei Linfonodi Mammari Interni Nel Trattamento Del Cancro Mammario 1

From 1948 to May 1961, 304 patients underwent radical mastectomy with dissection of the internal mammary lymph node chain at the Cancer Institute of Milan. Out of these, 199 were submitted to extrapleural removal of internal mammary lymph nodes, and 105 to an «en bloc » removal, with sterno-costal toracectomy.

Of the 305 cases operated upon by the two different techniques, 72 (23.7 %) had internal mammary metastases. The internal mammary involvement was found to be frequent also in tumours of the lateral quadrants (20%). In addition, it could be demonstrated that a relation exists between size of the mammary tumour and frequency of internal mammary metastases. The latter were present in the 15 per cent of tumours less than 3 cm in diameter and in the 61 per cent of tumours 8 cm or more in diameter.

Out of the 156 cases with axillary invasion, 54 (41 %) had also internal mammary metastases. Out of the 148 cases without axillary invasion, 7 (4.7 %) had internal mammary metastases.

Of the 165 patients operated upon until 1956 (by extrapleural exeresis not «en bloc » with the primary tumour), 91 (55.5 %) were alive after 5 years. The 5-year survival of cases with axillary metastases only was demonstated to be of the 52.4 per cent, whereas it drops to 13.2 per cent in cases with axillary and internal mammary metastases.