Mattheiem W, Bourgeois P, Delcorde A, Stegen M, Frühling J
Breast and Pelvis Surgery Clinic, Institut Jules Bordet, Bruxelles, Belgium.
Eur J Surg Oncol. 1989 Dec;15(6):490-5.
The pathological status of the axillary nodes remains the single most determining factor for survival, local recurrence and disease-free interval in operable breast cancer. Radical axillary dissection results in better local control with or without systemic disease in all operable cases. In pathologically negative cases, radical axillary dissection decreases local recurrence rates and perhaps prolongs disease-free survival. In pathologically positive cases, radical axillary dissection improves local control only. Radical axillary dissection avoids axillary irradiation and so decreases the risk and the importance of lymphoedema. Perfect axillary dissection does not show a decisive advantage over less complete axillary dissection when the 'quality' of surgery is measured by lymphoscintigraphy, but it should be kept in mind that only total control of the local situation can ensure a patient free of distal spread at the time of first therapy.
腋窝淋巴结的病理状态仍然是可手术乳腺癌患者生存、局部复发和无病生存期的唯一最重要决定因素。在所有可手术病例中，根治性腋窝清扫术无论有无全身疾病均能更好地实现局部控制。在病理检查为阴性的病例中，根治性腋窝清扫术可降低局部复发率，并可能延长无病生存期。在病理检查为阳性的病例中，根治性腋窝清扫术仅能改善局部控制。根治性腋窝清扫术可避免腋窝放疗，从而降低淋巴水肿的风险和重要性。当通过淋巴闪烁显像评估手术“质量”时，完美的腋窝清扫术相较于不太彻底的腋窝清扫术并无决定性优势，但应牢记，只有全面控制局部情况才能确保患者在首次治疗时无远处转移。
