Komenaka Ian K, Bauer Valerie P, Schnabel Freya R, Joseph Kathie-Ann, Horowitz Elizabeth, Ditkoff Beth-Ann, El-Tamer Mahmoud B
Columbia-Presbyterian Medical Center, Comprehensive Breast Center, Columbia University, New York, NY, USA.
Arch Surg. 2004 Feb;139(2):175-8. doi: 10.1001/archsurg.139.2.175.
Interpectoral nodes can be the initial site of recurrent breast cancer.
Retrospective review.
Comprehensive breast center, located in a university-based tertiary care center.
All patients undergoing operations for breast cancer at our breast center from 1995 to 2002 were reviewed.
Patients with interpectoral node recurrence as the initial site of recurrent breast cancer were identified.
During the 8-year period, 4097 patients underwent surgical management for breast cancer. During this time, 4 patients (0.1%) had recurrence at the interpectoral nodes. Three of the 4 patients were node-negative at the original operation. All lesions were mammographically occult. Preoperative needle biopsy was effective in the confirmation of malignancy. All 4 underwent excision without complications.
Recurrence at the interpectoral nodes can be the initial site of surgical failure. These nodes may represent the site of primary drainage in a percentage of patients. The sentinel node identification technique, therefore, should diminish the number of patients affected by recurrence at this site. In patients with a palpable mass in the infraclavicular location, however, a high index of suspicion should be maintained. Workup should include additional breast imaging and needle biopsy prior to operation.
胸肌间淋巴结可能是复发性乳腺癌的初始部位。
回顾性研究。
位于一所大学附属三级医疗中心的综合乳腺中心。
对1995年至2002年期间在我们乳腺中心接受乳腺癌手术的所有患者进行了回顾。
确定以胸肌间淋巴结复发作为复发性乳腺癌初始部位的患者。
在这8年期间，4097例患者接受了乳腺癌手术治疗。在此期间，4例患者（0.1%）在胸肌间淋巴结出现复发。4例患者中有3例在初次手术时淋巴结为阴性。所有病变在乳腺钼靶检查中均为隐匿性。术前针吸活检对确诊恶性肿瘤有效。4例患者均接受了切除手术，无并发症发生。
胸肌间淋巴结复发可能是手术失败的初始部位。这些淋巴结在一定比例的患者中可能代表主要引流部位。因此，前哨淋巴结识别技术应能减少受该部位复发影响的患者数量。然而，对于锁骨下可触及肿块的患者，应保持高度怀疑。术前检查应包括额外的乳腺影像学检查和针吸活检。
