Cimmino Vincent M, Degnim Amy C, Sabel Michael S, Diehl Kathleen M, Newman Lisa A, Chang Alfred E
Division of Surgical Oncology, University of Michigan Comprehensive Cancer Center, Ann Arbor, Michigan 48109-0932, USA.
J Surg Oncol. 2004 May 1;86(2):74-7. doi: 10.1002/jso.20045.
Sentinel lymph node biopsy (SLNB) is rapidly becoming the standard of care in the treatment of women with early stage breast cancer. Male breast cancer although relatively rare, has typically been treated with mastectomy and axillary lymph node dissection (ALND). Men who develop breast carcinoma have the same risk as their female counterparts of developing the morbidities associated with axillary dissection. SLNB has been championed as a procedure aimed at preventing those morbidities. We recently have evaluated the role of SLNB in the treatment of men with early stage breast cancer.
Among the 18 men treated at the University of Michigan Medical Center for breast cancer from May 1998 to November 2002, 6 were treated with SLNB.
The mean tumor size was 1.6 cm. The mean patient age was 59.8 years. All of the patients had one or more sentinel lymph nodes identified. Two of the six did not have confirmatory axillary dissection. Three of the six had positive sentinel lymph nodes (50%). Only one of the three patients with a positive sentinel node had more nodes positive. One of the six patients had a positive node on frozen section and underwent immediate complete axillary dissection. This patient had no additional positive nodes. No patients in our series had immunohistochemical studies of the lymph nodes.
Men with early stage breast carcinoma may be offered the management option of SLNB since in the hands of experienced surgeons it has a success rate apparently equal to that in their female counterparts.
前哨淋巴结活检(SLNB)正迅速成为早期乳腺癌女性患者治疗的标准方法。男性乳腺癌虽然相对罕见,但通常采用乳房切除术和腋窝淋巴结清扫术(ALND)进行治疗。罹患乳腺癌的男性与女性患者一样,有发生与腋窝清扫相关并发症的风险。SLNB一直被倡导作为一种旨在预防这些并发症的手术。我们最近评估了SLNB在早期乳腺癌男性患者治疗中的作用。
在1998年5月至2002年11月间于密歇根大学医学中心接受乳腺癌治疗的18名男性患者中,6名接受了SLNB治疗。
肿瘤平均大小为1.6厘米。患者平均年龄为59.8岁。所有患者均发现一个或多个前哨淋巴结。6名患者中有2名未进行腋窝淋巴结清扫确认。6名患者中有3名前哨淋巴结阳性(50%)。3名前哨淋巴结阳性的患者中只有1名有更多阳性淋巴结。6名患者中有1名在冰冻切片时发现淋巴结阳性并立即进行了完整的腋窝清扫。该患者没有其他阳性淋巴结。我们系列中的患者均未对淋巴结进行免疫组化研究。
早期乳腺癌男性患者可以选择SLNB治疗,因为在经验丰富的外科医生手中,其成功率显然与女性患者相同。