以胸背血管分叉平面作为乳腺癌腋窝淋巴结清扫术下界的研究

目的 判断乳腺癌患者胸背血管分叉平面下方组织内是否存在淋巴结及其转移情况，分析能否以此平面作为腋窝淋巴结清扫术中胸背血管的解剖终点。方法 在进行腋窝淋巴结清扫术时，将胸背血管分叉平面下方组织切除后标以胸背血管分叉处淋巴结另送病理检查。结果 112例患者中有99例发生腋窝淋巴结转移，阳性率为88．4％；97例(86．6％)胸背动脉分叉平面下方为脂肪组织，有15例(13．4％)存在淋巴结，均未发现癌细胞转移。结论 多数病例胸背动脉分叉平面以下组织内不存在淋巴结。不论患者原发肿瘤大小、腋窝淋巴结有无转移、病理类型等因素如何，该处组织均未发现转移，且胸背血管分叉处位置较为固定，变异较少，可作为腋清扫范围的下界。

Study of taking the plane of furcation of thoracodorsal artery as lower bound of axillary lymph node dissection for breast cancer

Objective To study whether there are lymph nodes under the furcation of thoracodorsal artery of breast cancer patients and identify its metastasis situation, which can be regarded as the lower bound of axillary lymph node dissection. Methods When carries on the axillary lymph node dissection, we excise furcation organization and sign lymph nodes under the furcation of thoracodorsal artery, then deliver them to pathology inspection. Results 99 of 112 (88.4 %) cases have positive axillary lymph nodes, fatty tissue is found in the thoracodorsal artery furcation of 97 cases (86.6 %) and lymph nodes are found in 15 cases (13.4 %), neither of them occurs metastasis. Conclusions There are no lymph nodes under the furcation of thoracodorsal artery in most cases. Under this plane no metastasis was found in all of the cases in spite of the size of tumor, the metastasis situation of axillary lymph node or pathology type. Moreover, the position of this furcation is fixed and less variation, so we can take thoracodorsal artery as the lower bound of axillary lymph node dissection.