Kocher T, Zuber M, Harder F
Departement Chirurgie, Universität, Kantonsspital Basel.
Zentralbl Chir. 1998;123 Suppl 5:98-9.
The presence or absence of involved axillary lymph nodes is the single best predictor of survival of breast cancer, and important treatment decisions are based on it. For staging purpose as well as for local control a level I and II dissection is recommended. In order to lower the morbidity of axillary lymph node dissection less invasive treatment modalities have been evaluated. Beside the sentinel lymph node biopsy another new method is discussed: the endoscopic axillary lymph node dissection. After liposuction of the axillary fat the lymph nodes of level I and II are removed by endoscopy. With this technique enough lymph node can be removed which allows a sufficient staging as well as local control. This technique is not to be recommended for general use unless long term results have proven its value.
腋窝淋巴结有无转移是乳腺癌生存的最佳单一预测指标,重要的治疗决策以此为依据。为了进行分期以及局部控制,建议进行Ⅰ级和Ⅱ级清扫。为了降低腋窝淋巴结清扫的发病率,人们对侵入性较小的治疗方式进行了评估。除了前哨淋巴结活检,还讨论了另一种新方法:内镜腋窝淋巴结清扫术。在对腋窝脂肪进行抽脂后,通过内镜切除Ⅰ级和Ⅱ级淋巴结。通过这种技术可以切除足够数量的淋巴结,从而实现充分的分期和局部控制。除非长期结果证明其价值,否则不建议普遍使用该技术。