Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Ann Surg Oncol. 2011 Oct;18(11):3174-80. doi: 10.1245/s10434-011-1957-z. Epub 2011 Aug 23.
Lymphatic drainage of the breast is via subareolar and dermal lymphatics. The aim of this study was to determine whether distance of breast cancers from the skin and/or distance from the nipple impacts the likelihood of axillary nodal metastases.
A retrospective review was performed of sonographically visible T1 and T2 breast cancers with breast and axillary surgery performed at Mayo Clinic, Rochester, MN. Distance of tumor from the nipple was reviewed. Ultrasounds were reviewed to measure the distance of tumor from the skin.
Data were collected on 233 eligible T1 or T2 breast cancers, of which 177 (76%) were node negative and 56 (24%) were node positive. On multivariable analysis, tumor stage and lymphovascular invasion, as well as decreasing distance of the tumor from the nipple and decreasing distance of the tumor from the skin, were significantly associated with axillary lymph node positivity. Each 1-cm decrease in the distance of the tumor from the nipple was associated with a 23% increased likelihood of positive lymph nodes (odds ratio 1.23; P = .003). Each 1-mm decrease in the distance of the tumor from the skin was associated with a 15% increased likelihood of positive lymph nodes (odds ratio 1.15; P = .003).
T1 and T2 breast cancers located closer to the skin and those located closer to the nipple have a higher incidence of metastases to axillary lymph nodes. Distance from the skin and distance from the nipple should be considered when estimating a patient's likelihood of axillary nodal positivity.
乳房的淋巴引流通过乳晕下和真皮淋巴管。本研究的目的是确定乳腺癌距皮肤和/或距乳头的距离是否影响腋窝淋巴结转移的可能性。
对明尼苏达州罗切斯特市梅奥诊所行乳房和腋窝手术的 T1 和 T2 超声可见乳腺癌进行了回顾性研究。回顾了肿瘤距乳头的距离。超声检查以测量肿瘤距皮肤的距离。
共收集了 233 例符合条件的 T1 或 T2 乳腺癌患者的数据，其中 177 例（76%）为淋巴结阴性，56 例（24%）为淋巴结阳性。多变量分析显示，肿瘤分期和脉管侵犯，以及肿瘤距乳头的距离减小和肿瘤距皮肤的距离减小，与腋窝淋巴结阳性显著相关。肿瘤距乳头的距离每减少 1cm，腋窝淋巴结阳性的可能性增加 23%（优势比 1.23；P =.003）。肿瘤距皮肤的距离每减少 1mm，腋窝淋巴结阳性的可能性增加 15%（优势比 1.15；P =.003）。
T1 和 T2 乳腺癌位于更靠近皮肤和更靠近乳头的部位，转移至腋窝淋巴结的发生率更高。在估计患者腋窝淋巴结阳性的可能性时，应考虑皮肤距离和距乳头的距离。
