Papachristou D N, Kinne D W, Rosen P P, Ashikari R, Fortner J G
Surgery. 1979 Mar;85(3):322-8.
A study of 115 cutaneous melanomas of the breast demonstrated that these neoplasms follow different metastatic patterns than do primary carcinomas of the breast and require a different therapuetic approach. Lesions located below a 3 cm from the clavicle metastasized exclusively to the axillary nodes regardless of location. None of 19 internal mammary node chains examined histologically contained tumor deposits. Microstaging of the primary lesion correlated closely with prognosis and lymph node metastasis. Treatment by mastectomy (radical, modified, extended radical) offered no advantage over local excision of the primary plus axillary dissection. The latter procedure is recommended for all cutaneous melanomas of the breast which require node dissection. Mastectomy is not indicated unless the breast is in the field of wide local excision. Internal mammary node dissections are not indicated.
一项针对115例乳腺皮肤黑色素瘤的研究表明，这些肿瘤的转移模式与原发性乳腺癌不同，需要采用不同的治疗方法。位于锁骨下方3厘米以内的病变，无论其位置如何，均仅转移至腋窝淋巴结。经组织学检查的19条乳内淋巴结链中均未发现肿瘤沉积物。原发性病变的微分期与预后及淋巴结转移密切相关。乳房切除术（根治性、改良根治性、扩大根治性）与原发性肿瘤局部切除加腋窝淋巴结清扫术相比并无优势。对于所有需要进行淋巴结清扫的乳腺皮肤黑色素瘤，建议采用后一种手术方式。除非乳房在广泛局部切除的范围内，否则不建议进行乳房切除术。不建议进行乳内淋巴结清扫术。
