内乳淋巴结在乳腺癌治疗中的重要性

Significance of internal mammary lymph nodes in breast cancer therapy

目的探讨乳腺癌术后内乳淋巴结复发的原因,强调内乳淋巴结在乳腺癌治疗中的重要性。方法回顾性分析40例以内乳淋巴结转移为首先复发的女性乳腺癌患者的临床资料、初发病时的临床特征、手术方式、术后病理分期以及治疗经过。结果40例患者内乳淋巴结复发与患者年龄、经期状况、手术方式无关(P>0.05)。而与原发肿瘤直径、部位、腋窝淋巴结阳性数、临床病理分期相关(P<0.05)。结论位于乳腺内侧区、中央区的大块肿瘤(>3cm),腋窝淋巴结阳性数多(>3),且临床病理分期晚(IIb+IIIab)的乳腺癌患者,内乳淋巴结转移机率较高,须加强术后综合治疗。

Objective To explore the cause of tumor recurrence to internal mammary lymph nodes （ IMLN ） after breast cancer operation, and emphasize the therapeutic significance of IMLN in breast cancer therapy. Methods The clinical data of forty female patients with IMLN recurrence after operation were collected and analyzed retrospectively. The data included previous symptoms, operative procedures, pathology staging as well as postoperative treatments. Results The recurrence of IMLN of 40 patients was not correlated with patient age, menstruation, or operating procedures （ P 〉 0.05 ）. However, it was correlated with primary tumor diameter and location, number of positive axillary lymph nodes, and clinical pathology staging （P 〈0.05 ） . Conclusions The IMLN metastasis rate is high in the patients with large lesions （ 〉 3 cm ） of inner or central breast regions, more than 3 positive axillary nodes, and advanced clinical pathology staging （Ⅱb ＋ Ⅲa, b ）. Comprehensive therapy should be enforced in the patients with the high risk factors of recurrence.