Robot-Assisted Internal Mammary Lymph Node Chain Dissection for Breast Cancer

Abstract

Clinical Practice Points•Internal mammary node biopsy is important for us to make an appropriate locoregional lymph node staging and treatment decision.•However, till now, there is no an ideal method to detect out metastatic nodes in internal mammary lymph chain exactly.•Thoracoscopic internal mammary lymph chain dissection has been reported, but it is difficult to remove the left internal mammary nodes by this technique.•Our study indicated that robotic internal mammary node dissection is a feasible, minimally invasive and simple procedure, which can improve nodal staging and be used to treat patients with left sided internal mammary lymph metastases which may spared patients getting adjuvant radiation therapy and its subsequent effects on the heart.•The robotic internal mammary lymph chain dissection is sometimes recommended for tumors ≥5 cm, or axillary lymph nodes positive, positive surgical margins, or suspected internal mammary lymph node metastasis by CT, positron emission tomography-computed tomography examination, or ultrasonography examination. •Internal mammary node biopsy is important for us to make an appropriate locoregional lymph node staging and treatment decision.•However, till now, there is no an ideal method to detect out metastatic nodes in internal mammary lymph chain exactly.•Thoracoscopic internal mammary lymph chain dissection has been reported, but it is difficult to remove the left internal mammary nodes by this technique.•Our study indicated that robotic internal mammary node dissection is a feasible, minimally invasive and simple procedure, which can improve nodal staging and be used to treat patients with left sided internal mammary lymph metastases which may spared patients getting adjuvant radiation therapy and its subsequent effects on the heart.•The robotic internal mammary lymph chain dissection is sometimes recommended for tumors ≥5 cm, or axillary lymph nodes positive, positive surgical margins, or suspected internal mammary lymph node metastasis by CT, positron emission tomography-computed tomography examination, or ultrasonography examination.