[腋窝淋巴结阳性原发性乳腺癌患者腋窝清扫范围的探讨]
[Exploration of the extent of axillary dissection for patients with node positive primary breast cancer].
作者信息
Ouyang Tao, Li Jin-feng, Wang Tian-feng, Lin Ben-yao
机构信息
Breast Cancer Center, Beijing Cancer Hospital, the School of Oncology, Peking University, Beijing 100036, China.
出版信息
Zhonghua Wai Ke Za Zhi. 2005 Mar 1;43(5):298-300.
OBJECTIVE
To explore the frequency of the involvement of level III and interpectoral lymph nodes in patients with node-positive breast cancer, and discuss the necessity of completely axillary dissection in this subgroup of patients.
METHODS
Consecutive 291 cases underwent completely axillary dissections (level I/II/III and interpectoral node) according to identical procedure. Level I/II, Level III and interpectoral lymph nodes were sent separately for routine pathological examination.
RESULTS
Eighty-seven cases (29.9%) were proved to be node-positive. Among them, metastases were detected at level III lymph nodes in 18 cases (20.7%) and at interpectoral lymph nodes in 16 cases (18.3%), respectively. Twenty-five cases involved in level III and/or interpectoral lymph nodes. In a subgroup of 52 cases with primary tumor smaller than 5 cm and involved Level I/II lymph nodes less than 4, 6 cases (11.5%) were found metastases at level III and/or interpectoral lymph nodes.
CONCLUSIONS
It is reasonable to perform completely axillary nodes dissection including level III and interpectoral lymph nodes for patients with node-positive breast cancer.
目的
探讨淋巴结阳性乳腺癌患者Ⅲ级和胸肌间淋巴结受累情况，并讨论该亚组患者行腋窝完全清扫术的必要性。
方法
连续291例患者按相同步骤行腋窝完全清扫术（Ⅰ/Ⅱ/Ⅲ级及胸肌间淋巴结）。Ⅰ/Ⅱ级、Ⅲ级和胸肌间淋巴结分别送检常规病理检查。
结果
87例（29.9%）被证实为淋巴结阳性。其中，Ⅲ级淋巴结转移18例（20.7%），胸肌间淋巴结转移16例（18.3%）。25例累及Ⅲ级和/或胸肌间淋巴结。在52例原发肿瘤小于5 cm且Ⅰ/Ⅱ级淋巴结受累少于4个的亚组中，6例（11.5%）发现Ⅲ级和/或胸肌间淋巴结转移。
结论
对淋巴结阳性乳腺癌患者行包括Ⅲ级和胸肌间淋巴结的腋窝完全清扫术是合理的。
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