Internal mammary sentinel lymph node biopsy should still be performed, especially in the patient with clinically positive axillary lymph nodes.

Current studies suggest that the internal mammary sentinel lymph node biopsy (IM-SLNB) should not be performed routinely, for it did not alter clinical management of breast cancer patients in terms of adjuvant treatment. However, consideration should be given to the fact, the study population in all current research relate to IM-SLNB is the patients with clinically negative axillary lymph nodes. As internal mammary lymph nodes metastases are mostly found concomitantly with axillary metastases, clinical trials currently fail to evaluate the status of internal mammary lymph nodes who really in need. In consideration of the impact to staging and accurate indication of radiation to the internal mammary area, we recommend that research on IM-SLNB should still be encouraged, especially in patients with clinically positive axillary lymph nodes.