Internal mammary sentinel lymph node biopsy in clinical practice.

Almost all recent studies confirmed internal mammary sentinel lymph node biopsy (IM-SLNB) as an accurate and valuable technique to determine stage, prognosis, and best treatment option in breast cancer patients. Decision about local treatment of internal mammary lymph nodes (IMLN) is still being made based on Axillary lymph node (ALN) status. According to study results, there will be patients in positive ALN subgroup who just face complications of an unnecessary radiation to IMLNs and there will be patients in negative ALN subgroup who do not receive adjuvant radiation therapy they really need, if we insist to continue planning IMLN treatment based on ALN status. It seems that patients with bonafide drainage to IMLNs will benefit from IM-SLNB regardless of their ALN status.