Kemeny M M, Rivera D E, Terz J J, Benfield J R
Am J Surg. 1986 Jul;152(1):43-7. doi: 10.1016/0002-9610(86)90135-2.
The medical charts of 20 women with occult primary adenocarcinoma with axillary metastases were reviewed. An extensive radiologic workup in search of the primary lesion had a less than 7 percent positivity rate in the 74 studies carried out. Eleven patients were treated with mastectomy, 5 of whom were found to have carcinoma (49 percent). Four of the 11 patients, all with 14 or more positive axillary lymph nodes, died from breast cancer. Seven patients with no evidence of disease had an average of 4.6 positive axillary lymph nodes. Seven patients did not receive mastectomy, and one died from breast cancer. There was no significant difference in survival between the group treated with mastectomy and the group treated with axillary dissection. We conclude that mastectomy is unnecessary for patients with adenocarcinoma in axillary nodes but no apparent primary tumor.
回顾了20例隐匿性原发性腺癌伴腋窝转移女性患者的病历。在开展的74项研究中，为寻找原发灶进行的广泛影像学检查阳性率低于7%。11例患者接受了乳房切除术，其中5例被发现患有癌症（49%）。11例患者中有4例，均有14个或更多阳性腋窝淋巴结，死于乳腺癌。7例无疾病证据的患者平均有4.6个阳性腋窝淋巴结。7例患者未接受乳房切除术，1例死于乳腺癌。接受乳房切除术的组和接受腋窝清扫术的组在生存率上没有显著差异。我们得出结论，对于腋窝淋巴结有腺癌但无明显原发肿瘤的患者，乳房切除术是不必要的。
