乳腺癌内乳区淋巴结诊疗的研究进展

内乳区淋巴结（internal mammary lymph node，IMLN）引流整个乳腺约25%的淋巴液，其转移状况为乳腺癌预后指标之一，也是确定分期和制定治疗方案的重要依据。内乳区前哨淋巴结活检术（internal mammary-sentinel lymph node biopsy，IM-SLNB）作为微创诊断技术实现对IMLN的评估，有助于为患者制定更为准确的个体化治疗方案。在乳晕周围腺体内增加注射部位和注射剂量的新型注射技术显著提高内乳区前哨淋巴结（internal mammary sentinel lymph node，IMSLN）检出率，使得常规开展IM-SLNB成为可能。随着内乳区淋巴引流规律的深入研究，新型注射技术引导下的IM-SLNB的准确性目前已得到初步验证。本文将对乳腺癌内乳区淋巴结诊疗的研究进展进行综述。 

Advances in diagnosis and treatment of internal mammary lymph node of breast cancer

Internal mammary lymph nodes (IMLN) constitutes approximately 25% of the lymph nodes of the breast. The status of IMLN is one of the prognostic factors in breast cancer patients and essential to regional staging and adjuvant treatment choice. Inter-nal mammary-sentinel lymph node biopsy (IM-SLNB) is deemed a minimally invasive technique for the effective evaluation of IMLN sta-tus and useful in individualized diagnosis and treatment. Injecting radiotracer into glands around the areola through a modified injec-tion technique and at increased injection dose results in the high identification rate of internal mammary sentinel lymph node (IMSLN). Thus, routine IM-SLNB is feasible in clinical practice. Internal mammary lymph drainage pattern is extensively studied, and the accuracy of IM-SLNB guided by modified injection technique is gaining preliminary validation. This review summarizes the progress in diagnosis and treatment of IMLN of breast cancer.