Li Jianyi, Zhang Yang, Zhang Wenhai, Jia Shi, Gu Xi, Ma Yan, Li Dan
Department of Breast Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, China.
ISRN Oncol. 2013;2013:279013. doi: 10.1155/2013/279013. Epub 2013 Jan 20.
Purpose. Our aim was to assess the feasibility of using the intercostobrachial nerves (ICBNs) as a possible new anatomic landmark for axillaries lymph node dissection in breast cancer patients. Background Data Summary. The preservation of ICBN is now an accepted procedure in this type of dissection; however, it could be improved further to reduce the number of postoperative complications. The axillary space is divided into lower and upper parts by the ICBN-a thorough investigation of the metastasis patterns in lymph nodes found in this area could supply new information leading to such improvements. Methods. Seventy-two breast cancer patients, all about to undergo lymph node dissection and with sentinel lymph nodes identified, were included in this trial. The lymph nodes were collected in two groups, from lower and upper axillary spaces, relative to the intercostobrachial nerves. The first group was further subdivided into sentinel (SLN) and nonsentinel (non-SLN) nodes. All lymph nodes were tested to detect macro- and micrometastasis. Results. All the sentinel lymph nodes were found under the intercostobrachial nerves; more than 10 lymph nodes were located in that space. Moreover, when lymph nodes macrometastasize or micrometastasize above the intercostobrachial nerves, we also observe metastasis-positive nodes under the nerves; when the lower group nodes show no metastasis, the upper group is also metastasis free. Conclusions. Our results show that the intercostobrachial nerves are good candidates for a new anatomic landmark to be used in lymph node dissection procedure.
目的。我们的目的是评估将肋间臂神经（ICBNs）用作乳腺癌患者腋窝淋巴结清扫可能的新解剖标志的可行性。背景数据总结。在这类清扫术中，保留肋间臂神经现已成为一种公认的操作；然而，它可以进一步改进以减少术后并发症的数量。腋窝间隙被肋间臂神经分为上下两部分——对该区域发现的淋巴结转移模式进行全面研究可能会提供导致此类改进的新信息。方法。本试验纳入了72例即将接受淋巴结清扫且已确定前哨淋巴结的乳腺癌患者。根据肋间臂神经，将淋巴结分为两组，分别来自腋窝上下间隙。第一组进一步细分为前哨淋巴结（SLN）和非前哨淋巴结（非SLN）。对所有淋巴结进行检测以发现宏观和微观转移。结果。所有前哨淋巴结均位于肋间臂神经下方；该间隙中有10多个淋巴结。此外，当肋间臂神经上方的淋巴结发生宏观转移或微观转移时，我们也会在神经下方观察到转移阳性的淋巴结；当下组淋巴结无转移时，上组也无转移。结论。我们的结果表明，肋间臂神经是淋巴结清扫术中一个新的解剖标志的良好候选者。
