Gilissen F, Oostenbroek R, Storm R, Westenend P, Plaisier P
Department of Surgery, Albert Schweitzer Hospital, P.O. Box 444, NL-3300 AK Dordrecht, the Netherlands.
Eur J Surg Oncol. 2008 May;34(5):497-500. doi: 10.1016/j.ejso.2007.07.198. Epub 2007 Sep 12.
To determine the value of ultrasonography (US) and fine-needle aspiration (FNA) of the axilla in preventing futile sentinel node procedures (SNP) in breast cancer.
Between July 2004 and June 2005, 209 female patients were evaluated and treated in our clinic for histologically proven breast carcinoma. We analysed the results of axillary staging by US and FNA retrospectively. Furthermore, we correlated the histopathologic outcome of operative procedures with the preoperative findings during examination of the axilla.
Of the 209 patients, 195 underwent US of the axilla. In 67 patients, US was followed by FNA because of suspect lymph nodes in the axilla. Ninety-three of these 195 patients had axillary metastases. In 52 of these 93 patients, the metastases were detected prior to surgery, so that these 52 patients could be scheduled immediately for axillary lymph node dissection (ALND) and a futile SNP could be prevented. US/FNA yielded false-negative results in 41 cases, 13 of which had only a micrometastasis.
By preoperative US and FNA of the axilla in patients with breast cancer, half of the axillary metastases can be detected prior to surgery. In more than a quarter of breast cancer patients, a futile SNP can be prevented. Therefore, preoperative US of the axilla plus FNA are obligatory in patients with breast carcinoma.
确定腋窝超声检查（US）和细针穿刺活检（FNA）在预防乳腺癌前哨淋巴结活检（SNP）无效操作中的价值。
2004年7月至2005年6月期间，209例经组织学证实为乳腺癌的女性患者在我院接受评估和治疗。我们回顾性分析了腋窝超声检查和细针穿刺活检的腋窝分期结果。此外，我们将手术操作的组织病理学结果与腋窝检查的术前结果进行了关联。
209例患者中，195例接受了腋窝超声检查。其中67例因腋窝淋巴结可疑而在超声检查后进行了细针穿刺活检。这195例患者中有93例发生腋窝转移。在这93例患者中，52例在手术前检测到转移，因此这52例患者可立即安排腋窝淋巴结清扫术（ALND），从而避免了无效的前哨淋巴结活检。超声检查/细针穿刺活检在41例中产生了假阴性结果，其中13例仅存在微转移。
通过对乳腺癌患者进行术前腋窝超声检查和细针穿刺活检，半数腋窝转移可在手术前检测到。超过四分之一的乳腺癌患者可避免无效的前哨淋巴结活检。因此，乳腺癌患者术前腋窝超声检查加细针穿刺活检是必要的。
