Zavagno G, Carcoforo P, Franchini Z, Renier M, Barutta L, De Salvo G L, Maravegias K, Capitanio G, Nitti D, Lise M
Istituto Clinica Chirurgica II, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
Eur J Surg Oncol. 2005 Sep;31(7):715-20. doi: 10.1016/j.ejso.2005.04.006.
To determine the axillary recurrence rate in breast cancer patients with negative sentinel lymph nodes (SLN) who did not undergo further axillary lymph node dissection (ALND), and to establish whether this conservative axillary approach leads to an increased recourse to diagnostic axillary biopsy during the follow-up period because of the clinical suspicion of nodal recurrence.
In 479 patients, operated on for early breast cancer between 1998 and 2002 in five institutions, SLN biopsy was negative and no further axillary surgery was performed. SLN was localized using subdermal injection with 30-50 MBq of 99m-Tc-colloidal albumin. Follow-up controls were performed at 6-monthly intervals.
The mean number of SLNs removed was 1.4 per patient. Most patients (90.6%) were given adjuvant systemic therapy, based on the primary tumour characteristics. At a median follow-up of 35.8 months, no clinical axillary recurrence was found. No patient underwent surgical axillary biopsy for suspicious clinical or ultrasonographic findings.
Our results confirm that SLN biopsy without ALND in SLN-negative patients with early breast cancer is not followed by clinically evident axillary recurrence in the short-term.
确定前哨淋巴结（SLN）阴性且未接受进一步腋窝淋巴结清扫（ALND）的乳腺癌患者的腋窝复发率，并确定这种保守的腋窝处理方法是否会因随访期间临床怀疑淋巴结复发而导致更多地采用诊断性腋窝活检。
1998年至2002年期间，在五家机构对479例早期乳腺癌患者进行手术，SLN活检为阴性且未进行进一步的腋窝手术。通过皮下注射30 - 50 MBq的99m锝胶体白蛋白定位SLN。每6个月进行一次随访对照。
每位患者切除的SLN平均数量为1.4个。根据原发肿瘤特征，大多数患者（90.6%）接受了辅助全身治疗。中位随访35.8个月时，未发现临床腋窝复发。没有患者因可疑的临床或超声检查结果而接受手术腋窝活检。
我们的结果证实，早期乳腺癌SLN阴性患者在未进行ALND的情况下进行SLN活检，短期内不会出现临床明显的腋窝复发。
