Clinical Research Of Internal Mammary Sentinel Lymph Node In Breast Cancer

Objective:To find the best way of internal mammary lymph node for breast cancer,which from the internal mammary sentinel lymph node biopsy;And to analyze the risk factors of internal mammary lymph node metastasis and its effects in patients with breast cancer staging and adjuvant therapy;To investigate whether the internal mammary sentinel lymph node biopsy can guide the internal mammary lymph node dissection or to change the present situation of internal mammary lymph node neglect?Methods:We combined the preoperative lymph scintigraphy,intraoperative gamma probe with detection dye method for the 58 cases of early breast cancer patients in internal mammary sentinel lymph node biopsy,then routinely performed breast cancer surgery.Analyze the relative characteristics of the internal mammary sentinel lymph node with the pathological examination.Results:1 、 Radionuclide combined with methylene blue method of axillary SLN imaging rate of 100%,100% detection rate,the accuracy rate was 98.3%,the sensitivity rate was 94.7% and the false negative rate was 5%.The combination method of IM-SLN imaging rate was 19%,the detection rate was 100%,and the IM-SLN metastasis rate was 5%.2、Univariate analysis of patients’ IM-SLN transfer status with axillary lymph node metastasis status were correlated(P < 0.05),while with patients’ age,menopausal status,tumor size,tumor location,preoperative biopsy,pathological types there was no significant correlation(P > 0.05).3、After IMLN biopsy of the rib space,the final 5% of the patients changed the p N stage,3.4% of the patients changed the p TNM stage,5% of patients required internal radiotherapy,which avoid inadequate treatment.Conclusion:Axillary lymph node positivity is a high risk factor for IMLN metastasis.The IMLN biopsy in the rib space is safe and effective,but currently on the internal mammary sentinel lymph node imaging technology is still not mature,we need to improve the detection technology and methods of operation,also need to increase the sample size.It is expected to improve the imaging rate of IM-SLN,and ultimately to achieve the internal mammary sentinel lymph node biopsy to replace the internal mammary lymph node dissection,and provide accurate staging and more accurate individualized treatment for patients.