Marrazzo Antonio, Taormina Pietra, David Massimo, Riili Ignazio, Lo Gerfo Domenico, Casà Luigi, Noto Antonio, Mercadante Sebastiano
Department of Experimental Oncology and Clinical Application, University of Palermo, Palermo.
Chir Ital. 2007 Sep-Oct;59(5):687-91.
Quadrantectomy and associated sentinel lymph node biopsy (SLNB) is currently employed in most breast surgery centres as the gold standard in the treatment of early breast cancer. This approach has a modest morbidity and can usually be performed in a day-surgery regimen, leading to best acceptance by the patients. This reports outlines the experience of our Breast Unit with quadrantectomy and SLNB in day surgery for early breast cancer. One hundred patients presenting to our institution with primary invasive breast cancer measuring less than 3 cm and clinically negative axillary nodes underwent quadrantectomy and SLNB in day surgery. For 60 women with breast cancer the sentinel node was negative, so the only definitive surgical treatment was performed in the day-surgery regimen; 40 patients with positive sentinel nodes were hospitalised a second time for axillary dissection. In these patients that needed clearance of the axilla, SLNB was performed on the only positive node in 22 cases (55%). None of the patients admitted for quadrantectomy and SLNB in day surgery required re-hospitalisation after discharge. All patients proved to be fully satisfied with early discharge from hospital when questioned on the occasion of subsequent monitoring. Short-stay surgical programs in early invasive breast cancer treatment are feasible today owing to the availability of less invasive approaches such as quadrantectomy and SLNB. There are two main pointers to a distinct advantage for this kind of approach, i.e. recovery and psychological adjustment. Recovery from surgery is faster and the patient tends to play down the seriousness of the operation and to have a better mental attitude to neoplastic disease. Moreover, when performing quadrantectomy with SLNB in day surgery fewer than 50% of breast cancer patients (40% in our experience) require another surgical treatment, concluding the surgery in a single session.
象限切除术及相关前哨淋巴结活检（SLNB）目前在大多数乳腺外科中心被用作早期乳腺癌治疗的金标准。这种方法发病率较低，通常可在日间手术方案中进行，患者接受度高。本报告概述了我们乳腺科在早期乳腺癌日间手术中进行象限切除术及SLNB的经验。100例原发性浸润性乳腺癌患者，肿瘤直径小于3cm，临床腋窝淋巴结阴性，在日间手术中接受了象限切除术及SLNB。60例乳腺癌患者前哨淋巴结阴性，因此唯一的确定性手术治疗在日间手术方案中进行；40例前哨淋巴结阳性患者再次住院进行腋窝清扫。在这些需要腋窝清扫的患者中，22例（55%）仅对唯一的阳性淋巴结进行了SLNB。所有接受日间手术象限切除术及SLNB的患者出院后均无需再次住院。在后续随访询问时，所有患者均对早期出院表示完全满意。由于有象限切除术及SLNB等侵入性较小的方法，早期浸润性乳腺癌治疗的短期手术方案如今是可行的。这种方法有两个明显优势，即恢复和心理调适。手术恢复更快，患者往往淡化手术的严重性，对肿瘤疾病有更好的心理态度。此外，在日间手术中进行象限切除术及SLNB时，不到50%的乳腺癌患者（我们的经验是40%）需要再次手术治疗，手术可在一次手术中完成。
