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
Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Am J Surg. 2006 Jun;191(6):827-9. doi: 10.1016/j.amjsurg.2005.08.041.
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.
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.
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).
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.
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。
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。
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）。
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。
