Abstract:

Abstract:Objective To analyze the axillary lymph node metastasis of the different groups of breast cancer patients and  to explore  the opportunity to minimize the armpit circumscription in  early stage patients. Methods 80 breast cancer patients without any  neoadjuvant treatment were selected and treated with  standard modified radical mastectomy and received total axillary lymph node dissection. The lymph node samples were divided into four groups such  as level Ⅰ,level Ⅱ,level Ⅲ and Rotter’s lymph node  groups,then the  pathologic examination was performed. Results There were 55 (63.2%) patients with negative nodes and 32(36.8%) patients with positive nodes in total 87 patients. There was one patient with Rotter’s lymph node skip metastasis in level Ⅰ negative patients.There were 24 patients with 1-3 positive nodes in level Ⅰ group, and  there were 22(91.7%) patients with negative nodes in level Ⅱ group and there was one patient with positive Rotter’s lymph node in levels Ⅰ and Ⅱ groups(8.3% together). 7 patients had more than 3 positive nodes in level Ⅰ group, there were 2(28.6%) patients with negative nodes in level Ⅱ group,one patient (14.3%) with 1-3positive nodes,3 patients(42.9%) with 4-9 positive  nodes,one patient (14.3%) with more than 9 positive  nodes in level Ⅱ group and 4  patients with axillary lymph node metastasis in level Ⅲ group. Conclusion ①It  exists  the feasibility of giving level Ⅰ dissection to the patients with no clinical evidence of lymph node metastasis  and no findings of positive nodes in the procedure of operation. ②The patients with  1-3  positive  nodes in level Ⅰ group should accept a at least level Ⅱ dissection.③The patients with more than 3 positive nodes should accept levelⅡ cirumscription if there is no lymph node metastasis and should accept total armpit sirum soription if there is lymph node metastasis.

Key words: breast neoplasms； axillary lymph node metastasis； axillary lymphnode dissection