Chatzopoulos Stavros E, Behranwala Kasim A, Jayia Parveen, R Ragheed Al-Mufti, Cleator Susan J, Hadjiminas Dimitri J
Imperial College Healthcare NHS Trust, St Mary's hospital, London W21NY, UK.
World J Oncol. 2011 Dec;2(6):311-313. doi: 10.4021/wjon391w. Epub 2011 Dec 19.
Lymph node status is the most important clinicopathological prognostic factor for breast cancer patients and in most breast units it reflects only the axillary lymph nodes. A second often overlooked basin consists of the internal mammary lymph nodes (IMLNs) whose evaluation is not done as a routine step during the staging process. We highlight the need to consider incorporation of IMLNs into a patient's staging by presenting three cases of recurrent breast cancer with negative axilla and positive IMLN, a finding which altered their final management. We suggest that biopsy of IMLN should be a routine step in recurrent breast cancer when axillary lymphatics are disrupted by previous surgery although further research is required to define the optimal management of node positive cases.
淋巴结状态是乳腺癌患者最重要的临床病理预后因素，在大多数乳腺科室，它仅反映腋窝淋巴结情况。另一个常被忽视的区域是内乳淋巴结（IMLNs），在分期过程中，对其评估并非常规步骤。我们通过展示三例腋窝阴性而内乳淋巴结阳性的复发性乳腺癌病例，强调了将内乳淋巴结纳入患者分期的必要性，这一发现改变了他们的最终治疗方案。我们建议，当腋窝淋巴管因既往手术而中断时，内乳淋巴结活检应作为复发性乳腺癌的常规步骤，不过还需要进一步研究来确定淋巴结阳性病例的最佳治疗方案。
