乳腺癌前哨淋巴结活检及内乳淋巴绘图
Sentinel node biopsy and internal mammary lymphatic mapping in breast cancer.
作者信息
Johnson N, Soot L, Nelson J, Franzini M D, Vea H, Gruner S, Kulawiak L, Young K
机构信息
Legacy Cancer Services, Good Samaritan Hospital, Department of Surgery, Oregon Health Sciences University, Portland, Oregon, USA.
出版信息
Am J Surg. 2000 May;179(5):386-8. doi: 10.1016/s0002-9610(00)00365-2.
BACKGROUND
Currently outer quadrant breast tumors are not felt to have significant drainage to the internal mammary nodal chain. We evaluated the incidence of internal mammary sentinel nodes (IMSN) found with lymphoscintigraphy for all breast quadrants.
METHODS
Eighty women were prospectively studied by technitium-sulfur colloid injection, nuclear medicine imaging, and intraoperative gamma probe identification of sentinel nodes. IMSN detected were surgically removed.
RESULTS
Ten of 80 ( 12%) patients had IMSN identified in addition to axillary sentinel nodes (AXSN). Four tumors were located medially, 6 (60%) were in the outer quadrants. Metastatic disease was present in 3 of 10 women. Patients with positive IMSN also had positive AXSN.
CONCLUSIONS
Patients undergoing lymphatic mapping for the management of breast cancer should have radiolabelled tracer and gamma probe sentinel node identification regardless of tumor location in the breast.
背景
目前认为乳腺外象限肿瘤不会大量引流至内乳淋巴结链。我们评估了通过淋巴闪烁造影术在所有乳腺象限发现的内乳前哨淋巴结（IMSN）的发生率。
方法
对80名女性进行前瞻性研究，通过注射锝硫胶体、核医学成像以及术中使用γ探测器识别前哨淋巴结。对检测到的IMSN进行手术切除。
结果
80名患者中有10名（12%）除腋窝前哨淋巴结（AXSN）外还发现了IMSN。4例肿瘤位于内侧，6例（60%）位于外象限。10名女性中有3例存在转移性疾病。IMSN阳性的患者AXSN也为阳性。
结论
无论乳腺癌在乳腺中的位置如何，接受淋巴管造影术以管理乳腺癌的患者均应进行放射性标记示踪剂和γ探测器前哨淋巴结识别。
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