Research of three-dimensional localization for sentinel lymph node of breast cancer / 中国基层医药

ABSTRACT

Objective To investigate three-dimensional localization for sentinel lymph node (SLN) of breast cancer,and by which we can remove the SLNs directly.Methods The ipsilateral axillary lymph nodes of 40 patients were inspected by B-ultrasound and axillary artery and subscapular artery bifurcation point and its trend with Doppler B-ultrasound in the preoperation,then located them in the surface.We found SLNs using methylene blue as the mapping agent with endoscope during the operation,determined which lymphatic group the sentinel lymph node belonged and the spatial location and the surface projection according to the anatomical location.Results We found the three-dimensional location of SLNs in the group of 39 in 40 patients with endoscope,of which 34 cases located in central group,accounting for 87.18％ ;while 4 cases located in the subscapular group,accounting for 10.26％,and their spatial location was as follows:set the root of subscapular artery in this location as a starting point,the subscapular artery as a diameter,and made a diameter of 5cm circle to the bottom,then let the latissimus dorsi as the end,and made a quasi-cylinder through the circle to the axillary central.The height of the quasi-cylinder got up to the surface of the intercostal brachial nerve.Then set the nerve as the diameter of circle of quasi-cylinder,and the centre of circle was crosspoint of subscapnlar artery's surface projection with intercostal brachial nerve.The height of quasi-cylinder varies with somatotypes of the patients,its height was less than or equal to 5cm.What's more,the fiften enlarged lymph nodes located by B-ultrasound in the preoperation were all in the quasi-cylinder,and they were SLNs.Conclusion SLN lies in quasi-cylinder consisting of spatial location of subscapular group and central group lymph nodes.If the enlarged lymph nodes found by B-ultrasound are in above mentioned quasi-cylinder,they can be considered as the SLNs.Make a 5cm-incision parallelling the intercostal brachial nerve and intersecting the surface projection of subscapular artery in the surface of quasi-cylinder,then dissect toward the origin of the subscapular artery,you can find SLNs.