Noguchi M, Ohta N, Koyasaki N, Taniya T, Miyazaki I, Mizukami Y
Department of Surgery (II), Kanazawa University Hospital, School of Medicine, Japan.
Cancer. 1991 Nov 1;68(9):1918-25. doi: 10.1002/1097-0142(19911101)68:9<1918::aid-cncr2820680913>3.0.co;2-l.
Clinical, histologic, and biologic prognostic factors were examined in 144 patients with invasive breast cancer. It was determined whether variable prognostic factors, especially internal mammary lymph node metastases, would serve as a basis for the prognosis of breast cancer. In a univariate study, overall survival was significantly correlated with tumor size, axillary lymph node status, axillary and internal mammary lymph node metastases, and DNA ploidy status. Especially among patients with one to three positive axillary nodes, survival in case of internal mammary involvement were significantly lower than without internal mammary involvement. In a multivariate study, only axillary and internal mammary lymph node metastases were recognized as important, independent prognostic factors of survival, but neither axillary lymph node status nor DNA ploidy status appeared as important prognostic factors. It was concluded that internal mammary lymph node metastases is additional prognostic factor, especially in patients with one to three positive axillary nodes. Because axillary and internal mammary lymph node metastases could not be predicted from their clinical assessment, axillary lymph node dissection and biopsy of internal mammary nodes may be a useful staging procedure for these patients.
对144例浸润性乳腺癌患者的临床、组织学和生物学预后因素进行了研究。确定各种预后因素，尤其是内乳淋巴结转移，是否可作为乳腺癌预后的依据。在单因素研究中，总生存期与肿瘤大小、腋窝淋巴结状态、腋窝及内乳淋巴结转移以及DNA倍体状态显著相关。特别是在有1至3个腋窝淋巴结阳性的患者中，内乳受累患者的生存率显著低于无内乳受累患者。在多因素研究中，只有腋窝和内乳淋巴结转移被认为是生存的重要独立预后因素，而腋窝淋巴结状态和DNA倍体状态均未表现为重要的预后因素。得出的结论是，内乳淋巴结转移是一个额外的预后因素，尤其是在有1至3个腋窝淋巴结阳性的患者中。由于无法通过临床评估预测腋窝和内乳淋巴结转移，腋窝淋巴结清扫和内乳淋巴结活检可能是这些患者有用的分期程序。
