Kanai T
Nihon Geka Gakkai Zasshi. 1983 Feb;84(2):103-12.
Thirty five patients with mammary carcinoma were selected and completeness of lymph node dissection in modified radical mastectomy (MRM) was evaluated by two step procedures, i.e., MRM was performed at the first step and then standard radical mastectomy was added immediately following the first step. Complete axillary dissection was possible in all the cases with MRM, however, in some cases, excision of the other areas was insufficient, especially in an obese patient. There were number of cases in which the number of subclavicular lymph nodes and Halsted lymph nodes felt by palpation during the MRM operation did not correspond to the actual number of excised lymph nodes. MRM may be indicated in those cases where no metastasis is observed in the histological examination of the frozen section of axillary lymph nodes during operation and/or where there is no recognizable swelling of axillary lymph nodes under palpation when the size of breast lump is less than 2 cm in diameter.
选取35例乳腺癌患者，通过两步手术评估改良根治性乳房切除术（MRM）中淋巴结清扫的完整性，即第一步进行MRM，然后在第一步手术后立即追加标准根治性乳房切除术。所有行MRM的病例均可行腋窝彻底清扫，但在某些情况下，其他区域的切除不充分，尤其是肥胖患者。在许多病例中，MRM手术中触诊到的锁骨下淋巴结和哈尔斯泰德淋巴结数量与实际切除的淋巴结数量不符。对于术中腋窝淋巴结冰冻切片组织学检查未发现转移和/或当乳房肿块直径小于2 cm时触诊未发现腋窝淋巴结明显肿大的病例，可考虑行MRM。
