Fuhrman George M, Gambino Jamie, Bolton John S, Farr Gist, Jiang Xiaozhang
Department of Surgery, Ochsner Clinic Foundation, New Orleans, Louisiana 70121, USA.
Am Surg. 2005 Jul;71(7):564-9; discussion 569-70.
We conducted this study to provide one of the initial assessments of treatment outcomes for breast cancer patients evaluated with sentinel node mapping. All patients diagnosed with breast carcinoma, evaluated with sentinel node mapping, and followed for 5 years were divided into three groups depending on sentinel node(s) status. Group I (node negative) included 91 patients, 77 with invasive cancer, and 7 lost to follow-up. Of the remaining 70 patients, 3 (4.3%) suffered a distant recurrence and died, 1 developed an in-breast recurrence, and 9 (12.9%) developed a contralateral cancer during the study. Group II (IHC positive) included 28 patients. One (3.6%) developed a distant recurrence and died of breast cancer, and one developed a contralateral cancer during follow. Group III (H&E positive) included 36 patients with 1 lost to follow-up. Five patients (14.3%) died of breast cancer and two (5.7%) developed contralateral carcinomas during follow-up. The most striking observation was a lower than expected rate of distant recurrences in these patients followed for 5 years after a diagnosis of breast cancer and staging with sentinel node mapping. The ability to identify subtle nodal metastasis and design appropriate systemic therapeutic strategies may explain this finding.
我们开展这项研究，旨在对通过前哨淋巴结定位评估的乳腺癌患者的治疗结果进行初步评估之一。所有经诊断为乳腺癌、接受前哨淋巴结定位评估并随访5年的患者，根据前哨淋巴结状态分为三组。第一组（淋巴结阴性）包括91例患者，其中77例为浸润性癌，7例失访。在其余70例患者中，3例（4.3%）发生远处复发并死亡，1例发生乳腺内复发，9例（12.9%）在研究期间发生对侧癌。第二组（免疫组化阳性）包括28例患者。1例（3.6%）发生远处复发并死于乳腺癌，1例在随访期间发生对侧癌。第三组（苏木精-伊红染色阳性）包括36例患者，1例失访。5例患者（14.3%）死于乳腺癌，2例（5.7%）在随访期间发生对侧癌。最显著的观察结果是，这些在诊断乳腺癌并通过前哨淋巴结定位进行分期后随访5年的患者，远处复发率低于预期。识别微小淋巴结转移并设计适当的全身治疗策略的能力可能解释了这一发现。
