可手术乳腺癌术后补充锁上放疗适应症的探讨

Indication of Postmastectomy Adjuvant Supraclavicular Radiotherapy on Operable Breast Cancer

本文通过对46例可手术非选择性女性乳腺癌锁骨上三角淋巴脂肪组织清除术,前瞻性研究了可手术乳腺癌锁上淋巴结的隐性转移情况,发现在临床上无锁上淋巴结转移征象的可手水乳腺癌,锁上淋巴结隐性转移率为13.0％(6/46)。探讨了锁上淋巴结隐性转移与原发瘤的部位、大小、病理类型、腋窝淋巴结转移规律之间的关系,提出了可手术乳腺癌术后锁上区补充放疗的适应症。

Dissection of Lymphatic and fatty tissue of the supraclavicular triangular region was performed in 46 cases of oper- able non-selected female breast cancer. Occult metastasis in the supraclavicular lymph modes was studied in advance. It was found that the supraclavicular occult metastatic rate was 13%(6/46)in patients clinically devoid of supraclavicular metastasis. The authors discussed the relationship between supraclavieular occult metastasis and the site, size of the prima- ry tumor,pathologic type, and axillary lymph node involvement. The pros and cons of adjuvant supraclaviculor radio- therapy for postmastectomy patients with breast cancer were discussed. The authors suggest that indication of postoperative supraclavicular radiotherapy includes the following:(1)Apical nodes in the axilla are involved;(2)Carcinoma simplex with more than 8 axillary nodes involved but apical nodes intact; (3)Tumors greater than 5 cm across and number of involved nodes in excess of half the axillary nodes but no involve- ment of the apical nodes.