新辅助化疗后腋窝淋巴结计数较低。
Axillary lymph node count is lower after neoadjuvant chemotherapy.
作者信息
Neuman Heather, Carey Lisa A, Ollila David W, Livasy Chad, Calvo Benjamin F, Meyer Anthony A, Kim Hong Jin, Meyers Michael O, Dees E Claire, Collichio Fran A, Sartor Carolyn I, Moore Dominic T, Sawyer Lynda R, Frank Jill, Klauber-DeMore Nancy
机构信息
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
出版信息
Am J Surg. 2006 Jun;191(6):827-9. doi: 10.1016/j.amjsurg.2005.08.041.
BACKGROUND
Retrieval of fewer than 10 lymph nodes at axillary dissection (ALND) for breast cancer can represent anatomic variation or inadequate dissection. We postulated that despite aggressive ALND, a lower lymph node count is more frequent after neoadjuvant chemotherapy.
METHODS
Patients who received neoadjuvant chemotherapy followed by ALND were compared with patients who received surgery first. All patients received a level I and II ALND at a single institution by one of the breast surgeons. The number of nodes retrieved at ALND was dichotomized into categories (< 10 and > or = 10), and compared using Fisher exact test.
RESULTS
A total of 143 neoadjuvant and 170 surgery-first patients were studied. Patients treated with neoadjuvant chemotherapy were significantly more likely to have fewer than 10 lymph nodes retrieved at ALND than were the surgery-first patients (19/143 or 13% vs. 6/170 or 4%, P = .003).
CONCLUSIONS
A low lymph node count is more common in patients after treatment with neoadjuvant chemotherapy and should not be assumed to represent an incomplete ALND.
背景
乳腺癌腋窝淋巴结清扫术（ALND）中获取的淋巴结少于10个可能代表解剖变异或清扫不充分。我们推测，尽管进行了积极的ALND，但新辅助化疗后淋巴结计数较低的情况更为常见。
方法
将接受新辅助化疗后行ALND的患者与先接受手术的患者进行比较。所有患者均在单一机构由一名乳腺外科医生进行Ⅰ级和Ⅱ级ALND。将ALND获取的淋巴结数量分为两类（<10个和≥10个），并采用Fisher精确检验进行比较。
结果
共研究了143例新辅助化疗患者和170例先手术患者。新辅助化疗治疗的患者在ALND时获取的淋巴结少于10个的可能性显著高于先手术患者（19/143或13%对6/170或4%，P = .003）。
结论
新辅助化疗治疗后的患者淋巴结计数较低更为常见，不应将其视为ALND不完整。
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