乳癌の胸骨傍リンパ節転移例の検討

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  • INTERNAL MAMMARY LYMPH NODE METASTASIS OF THE BREAST CANCER

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A retrospective analysis was carried out on 379 patients who had experienced an internal mammary lymph node dissection among 2244 patients with breast cancer from 1969 to 1994. Seventy one (18.7%) patients were found to have metastatic internal mammary nodes. The 10-year survival rate of the internal mammary node-positive patients was worse than that of node-negative group (43% vs 72%, p<0.01). The frequency of internal mammary node metastases is significantly associated with the age of the patients (younger patients have a high risk, p<0.05), redness of the skin (p<0.01), nipple retraction (p<0.01), tumor size (p<0.05), axillary lymph node metastasis (p<0.01), tumor site (central and medial vs lateral, p<0.01) and histological vascular invasion (p<0.01). There was no correlation between the site of the primary tumor and the site of the internal mammary lymph node metastasis. Among the patients with central or medial breast cancer (more than T2 and more than N1b), the prognosis of the patients who had an extended mastectomy (n=63) was better than that of the patients having a conventional radical mastectomy (n=77) (p<0.05). These results suggested that the biopsy of the internal mammary lymph node at some intercostal space was not useful to assess the internal mammary lymph node metastasis and an intensive chemo-hormone-radiotherapy should be done for the patients with internal mammary lymph node metastasis.

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