He Qingqing, Zhuang Dayong, Tian Jun, Zheng Luming, Fan Ziyi, Li Xueliang
Department of Thyroid and Breast Surgery, Jinan Military General Hospital, Jinan 250031, P.R. China.
J Invest Surg. 2010 Dec;23(6):321-6. doi: 10.3109/08941939.2010.519429.
Internal mammary node (IMN) metastasis has a similar prognostic importance as axillary nodal involvement. However, sampling of IMN is not performed routinely.
To evaluate a simplified method for internal mammary sentinel node (IMSN) biopsy of breast cancer patients.
A combination of simultaneous perilesional and intradermal radiocolloid injections over the lesion was used. All IMSNs were confirmed by lymphoscintigraphy and Carbon Nanoparticles Suspension Injection preoperatively and excised extrapleurally through the intercostal muscles.
Twenty-three of the 94 patients were found to have metastatic disease in the IMSNs. Four of 65 patients had metastases in the IMNs but not in the axilla. All 23 patients with positive IMSN were upstaged and received radiation to the internal mammary chain. The time from separating the pectoral major muscle to touch the node was ranged 21-48 min. The detecting sensitivity combined with preoperative lymphoscintigraphy, intraoperative gamma probe detection, and intraoperative black dye methods for IMSN was 100%.
The approach used is a reliable surgical technique for removing IMSN. It can improve the nodal staging in breast cancer with IMN metastases.
内乳淋巴结（IMN）转移与腋窝淋巴结受累具有相似的预后重要性。然而，IMN的取样并非常规进行。
评估一种用于乳腺癌患者内乳前哨淋巴结（IMSN）活检的简化方法。
采用在病灶周围和皮内同时注射放射性胶体的联合方法。所有IMSN术前均经淋巴闪烁显像和碳纳米颗粒混悬液注射确认，并经肋间肌在胸膜外切除。
94例患者中有23例IMSN存在转移病灶。65例患者中有4例IMN有转移但腋窝无转移。所有23例IMSN阳性患者分期上调，并接受内乳链放疗。从分离胸大肌到触及淋巴结的时间为21 - 48分钟。IMSN术前淋巴闪烁显像、术中γ探针检测和术中黑色染料法联合检测的敏感性为100%。
所采用的方法是一种可靠的切除IMSN的手术技术。它可以改善伴有IMN转移的乳腺癌的淋巴结分期。
