Department of Surgical Oncology, Mater and Royal North Shore Hospital, University of Sydney, Sydney, Australia.
Eur J Surg Oncol. 2010 Jan;36(1):16-22. doi: 10.1016/j.ejso.2009.09.006. Epub 2009 Oct 20.
Internal mammary node (IMN) metastases are an important prognostic factor in breast cancer. However due to difficulty of access, most surgeons ignore these nodes, hence adjuvant treatment decisions may be compromised. Through mathematical modeling based on large datasets this study aims to estimate the current rate of IMN and sentinel node metastasis.
Models were created to estimate the current rate of axillary and IM sentinel node metastasis. Data from historical extended radical mastectomy series were analyzed to project contemporary rates of IMN metastasis. This information was coupled with derived models and contemporary datasets: a single-institution breast lymphoscintigraphy database (1992-2007) to establish lymphatic anatomy; and the Surveillance, Epidemiology and End-Results (SEER) registries in the US (2000-2003).
Rates of IMN metastasis and positive sentinel nodes were estimated and models derived to assist with predicting IMN status in patients. If high definition peritumoral lymphatic mapping were available, the predicted rates of positive sentinel nodes in the axilla (AN) and internal mammary chain (IMN) would be equal. We predicted the overall rate of IMN metastasis is approximately 39% the rate of positive sentinel AN.
Simplified models and algorithms can predict IMN status.
内乳淋巴结（IMN）转移是乳腺癌的一个重要预后因素。然而，由于难以触及，大多数外科医生忽略了这些淋巴结，因此辅助治疗的决策可能会受到影响。本研究旨在通过基于大型数据集的数学建模来估计当前 IMN 和前哨淋巴结转移的发生率。
建立模型来估计当前腋窝和 IM 前哨淋巴结转移的发生率。分析历史上广泛根治性乳房切除术系列的数据，以预测当代 IMN 转移的发生率。这些信息与推导模型和当代数据集相结合：一个单机构的乳房淋巴闪烁显像数据库（1992-2007 年）用于建立淋巴解剖结构；以及美国的监测、流行病学和最终结果（SEER）登记处（2000-2003 年）。
估计了 IMN 转移和阳性前哨淋巴结的发生率，并推导了模型来协助预测患者的 IMN 状态。如果有高清晰度的肿瘤周围淋巴管成像，预测腋窝（AN）和内乳链（IMN）的阳性前哨淋巴结的发生率将相等。我们预测 IMN 转移的总体发生率约为 39%，阳性 AN 前哨淋巴结的发生率。
简化的模型和算法可以预测 IMN 状态。
