Yamasaki N, Kodama H
Department of Surgery, Niigata Prefectural Central Hospital, Japan.
Nihon Geka Gakkai Zasshi. 1992 Nov;93(11):1427-32.
To study the influence of interpectoral lymph node (IPN) dissection on the prognosis of patients who underwent modified radical mastectomy, IPN was carefully dissected and studied pathologically on 168 cases of our breast cancer patients operated with modified radical mastectomy. There were 1.2 lymph nodes on an average in the interpectoral region, and they were almost 1-2mm in diameter. IPN metastases were found in 10 cases. (Tis: 0%, Stage I: 4.9%, Stage II: 5.7%, Stage III: 13%). Tumors located in outer quadrant in almost all these cases. Positive IPN were found in 6 (16%) of n1 alpha group, 1 (10%) of n1 beta group, and in 3 (50%) of n2 group. All these 3 cases of n2 died of distant metastasis and local recurrence. Two (1.7%) of axillary node (1a, 1b) negative patients had microinvolvement of cancer only in IPN, and are currently disease-free. These data suggest that IPN metastasis may occur even in the early breast cancer patients, and that may be controllable by lymph node excision. Therefore, routine and careful dissection of IPN through wide opening of sulcus interpectoralis is necessary for modified radical mastectomy and even for breast preserving operation.
为研究胸肌间淋巴结（IPN）清扫对接受改良根治性乳房切除术患者预后的影响，对我院168例行改良根治性乳房切除术的乳腺癌患者的IPN进行了仔细清扫并做病理研究。胸肌间区域平均有1.2个淋巴结，直径约1 - 2毫米。发现10例有IPN转移。（Tis：0%，Ⅰ期：4.9%，Ⅱ期：5.7%，Ⅲ期：13%）。几乎所有这些病例的肿瘤位于外象限。n1α组6例（16%）、n1β组1例（10%）、n2组3例（50%）发现IPN阳性。n2组的这3例均死于远处转移和局部复发。2例（1.7%）腋窝淋巴结（1a、1b）阴性患者仅在IPN有微小癌浸润，目前无病生存。这些数据表明，即使在早期乳腺癌患者中也可能发生IPN转移，且可通过淋巴结切除加以控制。因此，对于改良根治性乳房切除术甚至保乳手术，常规且仔细地通过充分打开胸肌间沟来清扫IPN是必要的。
