右乳癌保乳根治术

Right breast conservation operation

对于临床腋窝阴性的乳腺癌患者,进行前哨淋巴结活检已经成为标准的术式。以亚甲兰和纳米碳作为淋巴管显影剂,术前10 min在乳晕旁皮下注射,在腋窝以胸大肌外侧缘处沿皮纹切口,寻找显色的淋巴管和淋巴结,送术中快速冰冻病理检查。在等待冰冻期间,对肿块行保乳切除,取切缘送术中快速冰冻病理检查。此时冰冻报告:1枚前哨淋巴结阳性,故行腋窝淋巴结清扫术。肿块切缘均阴性,遂以钛夹标记残腔,缝合残腔。

For patients with clinically negative axillary nodes,sentinel lymph node biopsy has become a standard operation method in treating breast cancer. Methylene blue and nano carbon could be employed as lymphatic developers,which were injected subcutaneously into the para areola of the breast 10 minutes before operation. In the armpit,an incision was made along the skin texture at the lateral margin of the pectoralis major,searching for the blue stained lymphatic vessels and lymph nodes,which were harvested and sent for rapid pathological examination. During the waiting period,the breast tumor was excised,Pathological examination of the resection margin was performed. There was one positive sentinel lymph node,therefore the axillary lymph node was cleansed. Since the tumor margins were negative,titanium clips were used as markers of residual cavity margin.