内乳区淋巴结和腋窝淋巴结同是乳腺癌转移“第一站”淋巴结，其转移状况是确定分期和治疗方案的重要依据，但一直缺乏内乳区淋巴结的微创诊断技术，常导致乳腺癌分期不准确、治疗不足/过度。课题组前期研发的“新型注射技术”突破了传统注射技术内乳区显像率极低的瓶颈（13%→71%），可望实现内乳区前哨淋巴结活检术对内乳区淋巴结的微创诊断；但由于内乳区淋巴引流规律不明和扩大根治术弃用，导致无法直接验证其准确性，限制了该技术的临床应用。本项目运用正向（注射核素示踪剂，利用SPECT/CT图像融合技术，分析内乳区淋巴引流的生理规律）与逆向（注射不透X线造影剂，利用X线显像和三维重建，绘制内乳区淋巴引流的解剖图谱）结合的双向示踪技术，探索乳腺癌内乳区淋巴引流规律，并进一步构建淋巴引流模型。目的是验证“新型注射技术引导的内乳区前哨淋巴结活检术可以准确评估乳腺癌内乳区转移状况”假说，使乳腺癌患者获得个体化的诊疗策略。

As a first-echelon nodal drainage site in breast cancer, the status of the internal mammary lymph nodes and axillary lymph nodes is valueable both for staging and treatment choice. However, there still lack an effective and feasible minimally invasive technique for the diagnosis of the internal mammary lymph nodes, leading to the inaccurate staging and over/under-treatment. The “new injection technique” breaked through the bottle-neck of the low internal mammary visulization rate with traditional injection technique (13%→71%),and make the internal mammary sentinel lymph node biopsy possible to be a minimally invasive assessment for the internal mammary lymph nodes status; however, because of the internal mammary lymphatic drainage pattern is unclear and breast cancer extended radical resection was abandoned, we can’t verify the accuracy of “new injection technique” directly, limiting its clinical application. This project by using the forward (injection of radionuclide tracer, using SPECT/CT image fusion technology, physiological analysis of internal mammary lymph drainage pattern) and reverse (injection of radiopaque contrast medium, using X-ray imaging and 3D reconstruction, rendering internal mammary lymph drainage anatomy atlas) two-way tracing technique, explore internal mammary lymphatic drainage pattern in breast cancer, and further constructs the lymphatic drainage model. The aim is to verify the hypothesis that the internal mammary sentinel lymph node biopsy guided by the new injection technology could accurately assess the internal mammary metastases status in breast cancer, and further offer more individual diagnositic and therapy for patients with breast cancer.