Coroş M F, Stolnicu S, Georgescu R, Roşca A, Sorlea S, Dobre A, Podeanu D, Pălăsan A, Man C, Turcan C
Clinica Chirurgie 1, Spital Clinic Judeţean Mures, Romania.
Chirurgia (Bucur). 2009 Sep-Oct;104(5):557-64.
To establish the incidence of the axillary lymph node metastasis in breast cancer and some anatomo-clinical correlations useful for surgical act orientation.
The data from 450 patients, who underwent surgery for breast cancer between 2000 and 2007, were analyzed statistically according to some parameters: the age of the patients, the size and the location of the tumor, the hystopathological type, the elapsed time from the discovery of the tumor until surgery.
The tumoral stage was: stage 0--1.1%, I--7.11%, II--50.67%, III--33.78%, IV--7.33%. From the total amount of patients who underwent surgery, only 56.44% had axillary lymph node metastasis. The patients in the forth decade of life had more frequently axillary lymph node involvement, and also those from rural habitat (65.88%). The correlation between tumor dimension and lymph node involvement was: <2 cm--1.36%, 2-5 cm--48.71%, >5 cm--86.67%. The palpation of the armpit was associated in almost a quarter of cases with false negative or false positive diagnosis. There are a lot of locally advanced cases without axillary lymph node metastases.
Axillary lymph node status is strongly correlated with the tumor dimension and the elapsed time between diagnosis and treatment. The numerous cases of axillary lymphadenectomy without lymph node metastases (43.55%), even in locally advanced cases, advocate for a wider application of lymphatic mapping and sentinel lymph node biopsy, to avoid the pathology associated with those axillary dissections.
确定乳腺癌腋窝淋巴结转移的发生率以及一些有助于手术决策的解剖学与临床相关性。
对2000年至2007年间接受乳腺癌手术的450例患者的数据，根据一些参数进行统计学分析：患者年龄、肿瘤大小和位置、组织病理学类型、从发现肿瘤到手术的时间。
肿瘤分期为：0期——1.1%，I期——7.11%，II期——50.67%，III期——33.78%，IV期——7.33%。在接受手术的患者总数中，只有56.44%有腋窝淋巴结转移。40岁年龄段的患者腋窝淋巴结受累更为频繁，农村地区的患者也是如此（65.88%）。肿瘤大小与淋巴结受累之间的相关性为：<2 cm——1.36%，2 - 5 cm——48.71%，>5 cm——86.67%。在近四分之一的病例中，腋窝触诊与假阴性或假阳性诊断相关。有许多局部晚期病例无腋窝淋巴结转移。
腋窝淋巴结状态与肿瘤大小以及诊断和治疗之间的时间密切相关。即使在局部晚期病例中，大量腋窝淋巴结清扫术却无淋巴结转移的情况（43.55%），支持更广泛地应用淋巴绘图和前哨淋巴结活检，以避免与那些腋窝清扫相关的病理情况。
