乳腺癌第Ⅲ组淋巴结转移的探讨

Discussion on the level Ⅲ lymph node metastasis in breast cancer

目的：明确乳腺癌第Ⅲ组淋巴结转移的相关因素与转移规律，探讨术中对第Ⅲ组淋巴结清扫的原则与合理性。方法：对1999-2002年我院住院手术治疗行Ⅰ、Ⅱ、Ⅲ组淋巴结清扫术有完整病理资料的216例的Ⅲ组淋巴结情况进行归纳、总结，建立数据库，用SAS统计软件分析处理数据。结果：与第Ⅲ组淋巴结转移的相关因素为：肿瘤大小、肿瘤部位、腋淋巴结状况；而与患者年龄、月经状况、手术方式无关。第Ⅲ组淋巴结转移的发生率为28．7％。结论：对于腋淋巴结明显转移，肿块位于内侧及乳晕区的乳腺癌患者应行包括第Ⅲ组淋巴结的腋窝淋巴结完全清扫。

Objective：To make clear the correlative factors of axiUary lymph nodes level Ⅲ metastasis and pattern of metastasis in breast cancer and discuss the principle and necessity of complete axillary lymph node clearance during the modified radical masteetomy. Methods：The data of 216 patients, who had complete record and were operated with complete axiUary lymph node clearance （level Ⅰ、Ⅱ、Ⅲ ） in our hospital in 1999 to 2002, were summed up and set up a database. SAS system was used to analyze these data. Results： The rate of axiUary lymph nodes level Ⅲ metastasis was 28.7%. The correlative factors with axillary lymph nodes level Ⅲ metastasis from breast cancer were the size of tumor, location of tumor and axiUary lymph node status. There were no correlations with the patient＇s age, menopausal status, kinds of pathology type and the operation methods. Conclusion ：It is reasonable to perform complete axillary nodes clearance including level Ⅲ for breast cancer patients with node-positive and the tumor located in medical side of breast and areola.