摘要目的：通过内乳淋巴显像探讨乳腺癌患者内乳淋巴结转移及向对侧引流与骨转移的关系。方法：对35例乳腺癌切除术后并发生骨转移的患者和28例无骨转移的患者进行了内乳淋巴显像。仪器为GE公司产Millennium VG5 with Hawkeye，配低能高分辨率准直器。结果：①经内乳淋巴显像诊断骨转移组内乳淋巴结总的转移率、患侧向对侧引流率为62.9%，57.1%，同时有内乳淋巴转移和向对侧引流为40.0%；无骨转移组分别为32.1%，21.4%，10.7%,两组比较差异均有显著性（P均<0.05）。②仅有向对侧引流是骨转移组（17.1%）高于无转移组（10.7%），但差异无显著性。仅有内乳淋巴转移两组结果相似（22.9%和21.4%）。③骨转移组中，肿瘤位于内、中区的内乳淋巴结转移率（37.1%）及向对侧引流率（37.1%）均较外侧区者高（25.9%和20.0%）。结论：内乳淋巴结转移同时有向对侧引流极易发生骨骼转移；尚无内乳淋巴转移仅有向对侧引流者应高度警惕。
Abstract：Objective: To explore the relationship between internal mammary lymph node metastases, with or without drainage to the opposite side and bone metastases in breast cancer by internal mammary lymhposcintigraphy. Methods: Internal mammary lymhposcintigraphy had been performed in 35 patients of breast cancer with bone metastases and 28 patients without bone metastases. Results: ①The total rate of lymph node metastases of the internal mammary group was 62.9%. The rate of drainage to the contralateral side was 57.1%. In the bone metastatic group, the rate of internal mammary lymph node metastases associated with drainage to the opposite side was 40%. In the group without bone metastases they were 32.1%, 21.4%, and 10.7% respectively. There were significant difference(P<0.05) between the two groups. ②Only had shunt in bone metastases group(17.1%) was higher than that in the group without bone metastases(10.7%), but there was no significant difference between the two groups. Only had internal mammary lymph node metastases in the two groups had similar result(22.9% and 21.4%). ③The metastatic rate of internal mammary lymph node and shunt rate from affected side to opposite side of breast cancer lied in the internal and central region(37.1% and 37.1%) were higher than that in the exterion region(25.9% and 20%) of bone metastatic group. Conclusion: ①The patients with internal mammary node metastases and shunt from affected side to the opposite side meanwhile occurred bone metastases very easily. The patients only have shunt to opposite side in breast cancer must be on guard.
2007, Vol. 18 
