Fant Jerri S, Grant Michael D, Knox Sally M, Livingston Sheryl A, Ridl Kimberly, Jones Ronald C, Kuhn Joseph A
Department of Surgery, Baylor University Medical Center, Dallas, Texas, USA.
Ann Surg Oncol. 2003 Mar;10(2):126-30. doi: 10.1245/aso.2003.04.022.
This retrospective study was designed to provide a preliminary outcome analysis in patients with positive sentinel nodes who declined axillary dissection.
A review was conducted of patients who underwent lumpectomy and sentinel lymph node excision for invasive disease between January 1998 and July 2000. Those who were found to have sentinel lymph node metastasis without completion axillary dissection were selected for evaluation. Follow-up included physical examination and mammography.
Thirty-one patients were identified who met inclusion criteria. Primary invasive cell types included infiltrating ductal carcinoma, infiltrating lobular carcinoma, and mixed cellularity. Most primary tumors were T1. Nodal metastases were identified by hematoxylin and eosin stain and immunohistochemistry. Twenty-seven of the metastases were microscopic (<2 mm), and the remaining four were macroscopic. All patients received adjuvant systemic therapy. With a mean follow-up of 30 months, there have been no patients with axillary recurrence on physical examination or mammographic evaluation.
We have presented patients with sentinel lymph nodes involved by cancer who did not undergo further axillary resection and remain free of disease at least 1 year later. This preliminary analysis supports the inclusion of patients with subclinical axillary disease in trials that randomize to observation alone.
本回顾性研究旨在对前哨淋巴结阳性但拒绝腋窝清扫术的患者进行初步结局分析。
对1998年1月至2000年7月间因浸润性疾病接受肿块切除术和前哨淋巴结切除术的患者进行回顾。选择那些前哨淋巴结转移但未完成腋窝清扫术的患者进行评估。随访包括体格检查和乳房X线摄影。
确定了31例符合纳入标准的患者。原发性浸润细胞类型包括浸润性导管癌、浸润性小叶癌和混合细胞性。大多数原发性肿瘤为T1期。通过苏木精和伊红染色及免疫组化鉴定淋巴结转移。其中27例转移为微小转移（<2 mm），其余4例为宏观转移。所有患者均接受辅助全身治疗。平均随访30个月，体格检查或乳房X线摄影评估均未发现腋窝复发患者。
我们报告了癌症累及前哨淋巴结但未接受进一步腋窝切除术且至少1年后仍无疾病的患者。这一初步分析支持将亚临床腋窝疾病患者纳入仅随机分配至观察的试验中。
