1679例乳腺癌内乳淋巴结转移的高危因素分析

High risk factors of intramammary lymphatic metastasis in breast cancer patients received extended radical mastectomy:an analysis of 1679 cases

目的 探讨乳腺癌内乳淋巴结转移的高危因素。方法回顾性分析复旦大学附属肿瘤医院乳腺外科1956-2003年开展的l679例乳腺癌扩大根治术临床资料，选取病人年龄、肿瘤大小、肿瘤位置、腋窝淋巴结转移状况共4个乳腺癌内乳淋巴结转移可能相关的因素，分析不同情况下内乳淋巴结转移的高危因素。结果在选取的4个因素中，肿瘤大小不是影响内乳淋巴结转移的独立因素。腋窝淋巴结状况为内乳淋巴结转移的重要影响因素。不同情况下，肿瘤位置和年龄对内乳淋巴结转移的影响也不同。腋窝淋巴结阴性病人的内乳淋巴结转移率为4．4％，腋窝淋巴结1-3个阳性为18．8％，腋窝淋巴结4-6个阳性为28．1％，腋窝淋巴结≥7个为41．5％。结论有4个或以上腋窝淋巴结转移、内侧肿瘤合并腋窝淋巴结转移、肿瘤直径〉5．0cm的年轻病人是内乳淋巴结转移率的高危病人。

Objective To study the high risk factors of intramammary lymphatic metastasis in breast cancer patients received extended radical mastectomy. Methods The clinical data of 1679 breast cancer patients received extended radical mastectomy between 1956 and 2003 in the Cancer Hospital of Fudan University was analyzed retrospectively. Four individual variables, such as patient age, tumor size, tumor site and axillary nodes metastasis status, were selected to investigate high risk factors of the intramammary lymphatic metastasis in different conditions. Results Tumor size was not a independent predictor of intramammary lymphatic metastasis. Axillary node status was an important predictor of intramammary lymphatic metastasis. Tumor site and age had different effects on intramammary lymphatic metastasis in different conditions. The incidence of intramammary lymphatic metastasis is 4. 4% , 18. 8% ,28. 1% ,41.5% for patients with negative axillary nodes, 1 to 3 positive axillary nodes,4- 6 positive axillary nodes,7 or more positive axillary nodes, respectively. Conclusion Four or more positive axillary nodes, internal tumor and positive axillary nodes, young patients with tumor greater than 5.0cm were high risk factors of intramammary lymphatic metastasis.