Katz Angela, Gage Irene, Evans Sheila, Shaffer Margaret, Fleury Thomas, Smith Frederick P, Flax Richard, Drogula Cynthia, Petrucci Peter, Magnant Colette
Department of Radiation Oncology, Massachusetts General Hospital, 100 Blossom Street, Cox 31, Boston, MA 02114, USA.
Am J Surg. 2006 Jun;191(6):761-6. doi: 10.1016/j.amjsurg.2006.01.019.
The purpose of this study was to determine the rates of sentinel lymph node (SLN) positivity in patients with a final diagnosis of ductal carcinoma in situ (DCIS) or microinvasive breast cancer (MIC).
One hundred thirty patients underwent SLN mapping from 1998 to 2003 for DCIS or MIC.
One hundred nine patients with DCIS and 21 with MIC underwent SLN mapping. One patient with bilateral DCIS underwent 2 SLN procedures; therefore, the results of 131 SLN procedures are included. On hematoxylin and eosin (H&E) staining, 4 of 110 patients (3.6%) with DCIS had positive SLNs. Four additional patients had positive SLNs by IHC staining only (3.6%). Two of 8 patients underwent completion axillary dissection, and neither had additional involved nodes on completion axillary dissection. One of the 21 patients with MIC had positive SLNs by hematoxylin and eosin (H&E) (4.8%), and another had an involved SLN by IHC staining (4.8%). The patient with the positive SLN by H&E had 1 additional node on completion axillary dissection.
Rates of SLN positivity for patients with DCIS are modest, even in a high-risk population, and there is continuing uncertainty about its clinical importance.
本研究的目的是确定最终诊断为导管原位癌（DCIS）或微浸润性乳腺癌（MIC）的患者前哨淋巴结（SLN）阳性率。
1998年至2003年期间，130例患者因DCIS或MIC接受了SLN定位。
109例DCIS患者和21例MIC患者接受了SLN定位。1例双侧DCIS患者接受了2次SLN手术；因此，纳入了131次SLN手术的结果。苏木精和伊红（H&E）染色显示，110例DCIS患者中有4例（3.6%）SLN阳性。另外4例患者仅通过免疫组化（IHC）染色显示SLN阳性（3.6%）。8例患者中有2例接受了腋窝清扫术，腋窝清扫术后均无其他受累淋巴结。21例MIC患者中有1例通过苏木精和伊红（H&E）染色显示SLN阳性（4.8%），另1例通过免疫组化染色显示SLN受累（4.8%）。H&E染色显示SLN阳性的患者腋窝清扫术后还有1个额外的淋巴结。
DCIS患者的SLN阳性率适中，即使在高危人群中也是如此，其临床重要性仍存在不确定性。
