abstract
- The internal mammary lymphatics are the second most common site of regional metastasis in breast carcinoma. However, because of their retrosternal location, they rarely become clinically evident. This report describes a patient with a parasternal breast carcinoma metastasis arising from internal mammary lymphatics. The metastasis caused symptoms for more than 3 years before the primary tumor was discovered. The pathologic elements underlying this unusual presentation along with the treatment options and the surgical management with extended mastectomy are discussed in detail.