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目的了解腋窝淋巴结阳性乳腺癌患者胸肌间及第Ⅲ级淋巴结受累的发生频率,探讨对腋窝淋巴结阳性乳腺癌患者进行腋窝淋巴结完全清扫的合理性。方法连续实施乳腺癌第Ⅰ、Ⅱ、Ⅲ级和胸肌间淋巴结清扫术291例,单独标记第Ⅲ级和胸肌间淋巴结,手术后常规病理学检查。结果87例(299%)腋窝淋巴结阳性患者中,胸肌间淋巴结癌受累16例(183%),第Ⅲ级淋巴结癌受累18例(207%),第Ⅲ级和(或)胸肌间淋巴结受累者25例(287%),原发肿瘤小于5cm、第Ⅰ、Ⅱ级阳性淋巴结少于4枚的52例患者中,第Ⅲ级和(或)胸肌间淋巴结受累6例(115%)。结论对腋窝淋巴结阳性的乳腺癌患者应实施包括第Ⅲ级和胸肌间淋巴结的腋窝淋巴结完全清扫。
Objective To investigate the frequency of breast parenchyma and grade Ⅲ lymph node involvement in patients with axillary lymph node positive breast cancer and explore the rationality of axillary lymph node dissection in patients with axillary lymph node positive breast cancer. Methods A total of 291 cases of breast cancer Ⅰ, Ⅱ, Ⅲ grade and interspinous lymph node dissection were consecutively performed. The grade Ⅲ and pectoral lymph nodes were marked separately and routine pathological examination was performed after the operation. Results Among 87 cases (299%) of axillary lymph node positive patients, there were 16 cases (183%) of inter-psoas lymph node cancer, 18 cases (207%) of grade Ⅲ lymph node cancer, Of the 52 patients (287%) with less than 5 cm of primary tumor and less than 4 of grade I and II positive lymph nodes, 6 (115%) had grade III and / or pectoral lymph nodes involvement. Conclusion The patients with axillary lymph node-positive breast cancer should complete the axillary lymph node dissection including grade Ⅲ and inter-psoas lymph nodes.