Mahajna Ahmad, Hershko Dan D, Israelit Shlomi, Abu-Salih Adel, Keidar Zohar, Krausz Michael M
Department of Surgery A, Rambam Medical Center, Technion Faculty of Medicine, Haifa, Israel.
Isr Med Assoc J. 2003 Aug;5(8):556-9.
The histologic status of axillary lymph nodes is one of the most important prognostic factors in breast cancer and influences the management of these patients. Axillary lymph node dissection was traditionally performed in all patients to obtain this information but this procedure carries a considerable rate of complications. Recently, sentinel lymph node biopsy has emerged as an accurate and minimally invasive tool for predicting the axillary nodal status and has become the standard of care in selected patients with breast cancer.
To examine the accuracy of SLN biopsies performed by surgical residents during surgical resident training.
This prospective, randomized controlled study included 100 consecutive patients with clinically early breast cancer (T1-T2, N0, M0). Lymphatic mapping was performed using radiotracers, blue dye, or both. Formal axillary lymph node dissection completed the operations in all patients. All operations were performed by surgical residents under the supervision of senior surgeons.
The overall rate of identification of sentinel lymph nodes was 92%. The accuracy of SLN biopsy in reflecting the axillary nodal status was 96% with a false negative rate of 5.7%.
Sentinel lymph node biopsy is an accurate method for the evaluation and staging of regional lymph nodes in breast cancer patients. A dedicated instruction program for surgical residents may increase the standard of care and lead to highly trained surgeons in the management of early breast cancer.
腋窝淋巴结的组织学状态是乳腺癌最重要的预后因素之一，影响着这些患者的治疗管理。传统上，所有患者都要进行腋窝淋巴结清扫以获取该信息，但该手术并发症发生率较高。最近，前哨淋巴结活检已成为预测腋窝淋巴结状态的一种准确且微创的工具，并已成为部分乳腺癌患者的标准治疗方法。
评估外科住院医师在培训期间进行前哨淋巴结活检的准确性。
这项前瞻性随机对照研究纳入了100例连续的临床早期乳腺癌患者（T1-T2，N0，M0）。使用放射性示踪剂、蓝色染料或两者进行淋巴绘图。所有患者均完成了正式的腋窝淋巴结清扫。所有手术均由外科住院医师在资深外科医生的监督下进行。
前哨淋巴结的总体识别率为92%。前哨淋巴结活检反映腋窝淋巴结状态的准确率为96%，假阴性率为5.7%。
前哨淋巴结活检是评估乳腺癌患者区域淋巴结和进行分期的准确方法。为外科住院医师制定专门的培训计划可能会提高治疗水平，并培养出在早期乳腺癌治疗方面训练有素的外科医生。
