乳腺内淋巴结肿大 (IML) 在乳腺癌分期和预后中发挥着重要作用。我们的目的是评估 IML 检测方法、IML 如何影响新辅助化疗 (NAC) 的反应以及肿瘤学结果。我们评估了 2010 年至 2022 年参加 I-SPY-2 临床试验的患者。我们捕获了 IML 检测的放射照相方法（磁共振成像 [MRI]、正电子发射断层扫描/计算机断层扫描 [PET/CT] 或两者）并将 IML 患者与非 IML 患者进行比较。通过双变量分析比较局部区域复发率 (LRR)、远处复发率 (DR) 和无事件生存率 (EFS)。在 2095 名患者中，198 名 (9.5%) 在治疗前影像学上报告有 IML。 IML 检测方法仅 MRI 154 例（77.8%），仅 PET/CT 11 例（5.6%），两者兼用 33 例（16.7%）。与 IML 相关的因素包括年龄较小 (p = 0.001)、肿瘤较大 (p < 0.001) 和肿瘤分级较高 (p = 0.027)。 IML 组的病理完全缓解 (pCR) 略高（41.4% 对比 34.0%；p = 0.03）。乳房或腋窝手术没有差异（p = 0.41 和 p = 0.16），但 IML 患者接受放射治疗的可能性更大（68.2% vs. 54.1%；p < 0.001）。中位随访时间为 3.72 年（范围 0.4-10.2），IM 与 IM- 之间的 LRR（5.6% vs. 3.8%；p = 0.25）、DR（9.1% vs. 7.9%；p = 0.58），或 EFS（61.6% 与 57.2%；p = 0.48）。对于有和没有 pCR 的患者来说都是如此。在这一大群接受 NAC 治疗的患者中，结果并未受到 IML 的负面影响。我们证明，IML 会影响治疗选择，但在采用现代 NAC 和多学科疾病管理治疗时并不是一个不良的预后指标。© 2024。外科肿瘤学会。

Internal mammary lymphadenopathy (IML) plays a role in breast cancer stage and prognosis. We aimed to evaluate method of IML detection, how IML impacts response to neoadjuvant chemotherapy (NAC), and oncologic outcomes.We evaluated patients enrolled in the I-SPY-2 clinical trial from 2010 to 2022. We captured the radiographic method of IML detection (magnetic resonance imaging [MRI], positron emission tomography/computed tomography [PET/CT], or both) and compared patients with IML with those without. Rates of locoregional recurrence (LRR), distant recurrence (DR) and event-free survival (EFS) were compared by bivariate analysis.Of 2095 patients, 198 (9.5%) had IML reported on pretreatment imaging. The method of IML detection was 154 (77.8%) MRI only, 11 (5.6%) PET/CT only, and 33 (16.7%) both. Factors associated with IML were younger age (p = 0.001), larger tumors (p < 0.001), and higher tumor grade (p = 0.027). Pathologic complete response (pCR) was slightly higher in the IML group (41.4% vs. 34.0%; p = 0.03). There was no difference in breast or axillary surgery (p = 0.41 and p = 0.16), however IML patients were more likely to undergo radiation (68.2% vs. 54.1%; p < 0.001). With a median follow up of 3.72 years (range 0.4-10.2), there was no difference between IM+ versus IM- in LRR (5.6% vs. 3.8%; p = 0.25), DR (9.1% vs. 7.9%; p = 0.58), or EFS (61.6% vs. 57.2%; p = 0.48). This was true for patients with and without pCR.In this large cohort of patients treated with NAC, outcomes were not negatively impacted by IML. We demonstrated that IML influences treatment selection but is not a poor prognostic indicator when treated with modern NAC and multidisciplinary disease management.© 2024. Society of Surgical Oncology.