淋巴结阳性乳腺癌腋窝清扫范围探讨  

Exploration of the extent of axillary dissection for patients with node positive primary breast cancer

作　　者：欧阳涛[1] 李金锋[1] 王天峰[1] 林本耀[1] 

机构地区：[1]北京大学临床肿瘤学院暨北京肿瘤医院乳腺癌防治中心,100036

出　　处：《中华外科杂志》2005年第5期298-300,共3页Chinese Journal of Surgery

基　　金：北京市卫生局重点学科基金资助项目(1998卫科重字10号)

摘　　要：目的了解腋窝淋巴结阳性乳腺癌患者胸肌间及第Ⅲ级淋巴结受累的发生频率,探讨对腋窝淋巴结阳性乳腺癌患者进行腋窝淋巴结完全清扫的合理性。方法连续实施乳腺癌第Ⅰ、Ⅱ、Ⅲ级和胸肌间淋巴结清扫术291例,单独标记第Ⅲ级和胸肌间淋巴结,手术后常规病理学检查。结果87例(299%)腋窝淋巴结阳性患者中,胸肌间淋巴结癌受累16例(183%),第Ⅲ级淋巴结癌受累18例(207%),第Ⅲ级和(或)胸肌间淋巴结受累者25例(287%),原发肿瘤小于5cm、第Ⅰ、Ⅱ级阳性淋巴结少于4枚的52例患者中,第Ⅲ级和(或)胸肌间淋巴结受累6例(115%)。结论对腋窝淋巴结阳性的乳腺癌患者应实施包括第Ⅲ级和胸肌间淋巴结的腋窝淋巴结完全清扫。Objective To explore the frequency of the involvement of level Ⅲ and interpectoral lymph nodes in patients with node-positive breast cancer, and discuss the necessity of completely axillary dissection in this subgroup of patients. Methods Consecutive 291 cases underwent completely axillary dissections (level Ⅰ/Ⅱ/Ⅲ and interpectoral node) according to identical procedure. Level Ⅰ/Ⅱ, Level Ⅲ and interpectoral lymph nodes were sent separately for routine pathological examination. Results Eighty-seven cases (29.9%) were proved to be node-positive. Among them, metastases were detected at level Ⅲ lymph nodes in 18 cases (20.7%) and at interpectoral lymph nodes in 16 cases (18.3%), respectively. Twenty-five cases involved in level Ⅲ and/or interpectoral lymph nodes . In a subgroup of 52 cases with primary tumor smaller than 5 cm and involved Level Ⅰ/Ⅱ lymph nodes less than 4, 6 cases (11.5%) were found metastases at level Ⅲ and/or interpectoral lymph nodes. Conclusions It is reasonable to perform completely axillary nodes dissection including level Ⅲ and interpectoral lymph nodes for patients with node-positivebreast cancer.

关 键 词：乳腺癌 阳性 腋窝淋巴结 患者 淋巴结受累 胸肌 原发肿瘤 

分 类 号：R737.9[医药卫生—肿瘤] R735[医药卫生—临床医学]