Fujii Takaaki, Yajima Reina, Matsumoto Asuka, Yamaki Sayaka, Uchida Nobuyuki, Tsutsumi Soichi, Asao Takayuki, Kuwano Hiroyuki
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Japan.
Breast Care (Basel). 2010;5(2):102-104. doi: 10.1159/000301617. Epub 2010 Apr 21.
Intramammary lymph nodes (ILN) are often diagnosed by final histological examination. Recently, sentinel lymph node biopsy (SLNB) has been developed as a new standard in the treatment of breast cancer. However, reports describing intramammary sentinel nodes (ISLNs) are relatively rare, and the clinical significance of metastases in ISLNs is still unclear. CASE REPORT: We herein report a patient with breast cancer with an ISLN that was detected prior to surgery. In the current case, the ISLN contained foci of carcinoma, but the axillary SLNs (aSLN) did not contain such foci. Previous reports related to ISLNs and aSLNs, including our case, are reviewed. Interestingly, there was no case with negative ISLNs and positive aSLNs. CONCLUSIONS: The current and previous cases have shown that axillary lymph node dissection (ALDN) might rely on the aSLN status but not on the ISLN status. The effect on the prognosis or clinical significance in cases with positive ISLNs has not been fully elucidated. Cases of ISLNs found by SLN navigation are discussed in relation to their clinical significance.
乳腺内淋巴结（ILN）通常通过最终组织学检查来诊断。近年来，前哨淋巴结活检（SLNB）已成为乳腺癌治疗的新标准。然而，关于乳腺内前哨淋巴结（ISLN）的报道相对较少，且ISLN转移的临床意义仍不明确。病例报告：我们在此报告1例术前检测到ISLN的乳腺癌患者。在本病例中，ISLN含有癌灶，但腋窝前哨淋巴结（aSLN）未发现此类病灶。对包括我们病例在内的既往有关ISLN和aSLN的报告进行了回顾。有趣的是，尚无ISLN阴性而aSLN阳性的病例。结论：当前及既往病例均表明，腋窝淋巴结清扫术（ALDN）可能依赖于aSLN状态而非ISLN状态。ISLN阳性病例对预后的影响或临床意义尚未完全阐明。对通过SLN导航发现的ISLN病例的临床意义进行了讨论。
