Olliff J F, Cherryman G R
Department of Radiology, Royal Marsden Hospital, Sutton, Surrey.
Clin Radiol. 1990 Jan;41(1):31-3. doi: 10.1016/s0009-9260(05)80928-6.
Carcinoma of the breast commonly recurs in the axilla. A nodal mass may be palpable and computed tomography (CT) is frequently requested in order to differentiate recurrent tumour from the longer term effects of surgery and radiotherapy. We have reviewed the CT scans of 35 such patients referred consecutively to our CT unit. CT only detected the presence of recurrent tumour in one patient in whom a mass could not be palpated. This patient had a previously irradiated 'wooden' axilla making clinical examination impossible. CT failed to diagnose recurrence in two patients; one with disease in normal sized nodes and the other with axillary vein thrombosis. We conclude that CT of the axilla only appears to be of value when the axilla is impossible to palpate due to previous treatment. The key to the diagnosis of axillary tumour recurrence is careful palpation supplemented by aspiration cytology of any mass. When no mass is evident on clinical examination, CT is unlikely to demonstrate disease.
乳腺癌通常会在腋窝复发。可能可触及淋巴结肿块，经常会要求进行计算机断层扫描（CT），以便将复发性肿瘤与手术和放疗的长期影响区分开来。我们回顾了连续转诊至我们CT科室的35例此类患者的CT扫描结果。CT仅在1例无法触及肿块的患者中检测到复发性肿瘤的存在。该患者之前接受过放疗，腋窝呈“木样”，无法进行临床检查。CT未能诊断出2例患者的复发情况；1例患者的正常大小淋巴结中有病变，另1例患者有腋静脉血栓形成。我们得出结论，仅当由于先前治疗导致腋窝无法触及时，腋窝CT似乎才有价值。腋窝肿瘤复发诊断的关键是仔细触诊，并对任何肿块进行细针穿刺细胞学检查。当临床检查未发现明显肿块时，CT不太可能显示病变。
