Hill N S, Ege G N, Greyson N D, Mahoney L J, Jirsch D W
Can J Surg. 1983 Nov;26(6):507-9.
In a prospective trial, 89 women with breast lumps underwent bilateral axillary and internal mammary lymphoscintigraphy preoperatively, using technetium-99m antimony sulfide colloid. All scans were interpreted blindly by three separate observers. Breast biopsy was then performed; if the biopsy specimen showed malignant tumour, definitive therapy was performed with axillary dissection. The interpretation of the axillary and internal mammary lymphoscintigrams was subsequently compared with the histologic assessment of the axillary nodes. Of the 89 women, 54 had benign disease and 35 had cancer. The internal mammary lymphoscintigram was considered to show abnormality in only 1 of the 54 patients with benign disease. One patient with cancer was eliminated from the review. Sixteen of the remaining 34 patients had axillary node metastases. Of these, 8 had an abnormal internal mammary lymphoscintigram. Only 2 of the 18 patients with cancer but no axillary metastases had an abnormal internal mammary lymphoscintigram. One bilateral axillary lymphoscintigram in the 54 patients with benign disease was discarded for technical reasons. The axillary lymphoscintigram was accurate in 52 of the remaining 53 patients. Two such scintigrams in the 35 patients with breast cancer were discarded for technical reasons. The axillary lymphoscintigram indicated abnormalities in 12 of 16 patients with axillary nodal metastases but appeared normal in 13 of 17 patients without axillary metastases. Lymphoscintigraphy may play a valuable role in the staging of breast cancer in the future.
在一项前瞻性试验中，89例有乳腺肿块的女性术前接受了双侧腋窝和内乳淋巴闪烁造影，使用的是锝-99m硫化锑胶体。所有扫描结果均由三名独立的观察者进行盲法解读。随后进行乳腺活检；如果活检标本显示为恶性肿瘤，则进行腋窝清扫术作为确定性治疗。随后将腋窝和内乳淋巴闪烁造影的解读结果与腋窝淋巴结的组织学评估结果进行比较。89例女性中，54例患有良性疾病，35例患有癌症。在54例患有良性疾病的患者中，只有1例的内乳淋巴闪烁造影被认为显示异常。有1例癌症患者被排除在本次研究之外。其余34例患者中有16例发生腋窝淋巴结转移。其中，8例内乳淋巴闪烁造影异常。在18例患有癌症但无腋窝转移的患者中，只有2例内乳淋巴闪烁造影异常。54例患有良性疾病的患者中有1例双侧腋窝淋巴闪烁造影因技术原因被废弃。在其余53例患者中，腋窝淋巴闪烁造影在52例中是准确的。35例乳腺癌患者中有2例这样的闪烁造影因技术原因被废弃。腋窝淋巴闪烁造影显示16例有腋窝淋巴结转移的患者中有12例存在异常，但在17例无腋窝转移的患者中有13例显示正常。淋巴闪烁造影未来可能在乳腺癌分期中发挥重要作用。
