适合进行淋巴绘图和前哨淋巴结活检的有症状乳腺癌患者的术前选择。
Preoperative selection of symptomatic breast cancer patients appropriate for lymphatic mapping and sentinel node biopsy.
作者信息
Barry M, Cahill R A, Roche-Nagle G, Landers R, Walsh D, Bouchier-Hayes D J, Watson R G K
机构信息
Department of Surgery, Waterford Regional Hospital and Royal College of Surgeons in Ireland, Waterford, Ireland.
出版信息
Ir J Med Sci. 2007 Jul-Sep;176(2):91-6. doi: 10.1007/s11845-007-0034-x. Epub 2007 May 3.
BACKGROUND
This study examines whether preoperative ultrasound-assessed tumour diameter and diagnostic core biopsy-determined grade can be used to select those most likely to benefit from SLNB (i.e. those that are "node negative") before their definitive operation.
METHODS
Breast ultrasound (US) and a simultaneous core biopsy was performed in all patients at their initial presentation, and their estimates of tumor size and grade compared with the final pathological specimen (FPS).
RESULTS
Of the T1 group 47% had lymphatic metastases as did 49% of those with grade I or II cancers. By combining these measures, however, subgroups of patients with lower rates of nodal metastases were identified (32% of patients with T1, non-grade III disease had lymphatic disease while only 15% of those with T < 1.5 cm, non-grade III cancers had such metastases).
CONCLUSION
Combination of the US and ultrasound guided core biopsy (UGCB) may however identify subgroups unlikely to have axillary disease that are therefore suitable for SLNB.
背景
本研究旨在探讨术前超声评估的肿瘤直径和诊断性粗针活检确定的分级是否可用于在确定性手术前选择那些最有可能从前哨淋巴结活检（SLNB）中获益的患者（即那些“淋巴结阴性”的患者）。
方法
所有患者在初次就诊时均接受乳腺超声（US）检查并同时进行粗针活检，将其对肿瘤大小和分级的评估结果与最终病理标本（FPS）进行比较。
结果
T1组中47%有淋巴转移，I级或II级癌症患者中这一比例为49%。然而，通过综合这些指标，发现了淋巴结转移率较低的患者亚组（T1期、非III级疾病患者中有32%有淋巴疾病，而肿瘤直径<1.5 cm、非III级癌症患者中只有15%有此类转移）。
结论
然而，超声和超声引导下粗针活检（UGCB）相结合可能会识别出不太可能有腋窝疾病的患者亚组，因此适合进行前哨淋巴结活检。
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