Roumen R M H, Kuijt G P, Liem L H
Afd. Chirurgie, Máxima Medisch Centrum, locatie Veldhoven, Postbus 7777, 5500 MB Veldhoven.
Ned Tijdschr Geneeskd. 2008 Jan 5;152(1):13-9.
The sentinel lymph node (SLN) concept has become a standard option for the diagnosis and treatment of patients with primary invasive breast cancer. The implementation of this SLN concept has created a new category of patients: those who had breast-conserving therapy without complete axillary lymph node dissection following a negative SLN biopsy. In cases of local relapse in the ipsilateral breast, questions arise on the lymphatic drainage of this new tumour. Such is also the case for patients who have been treated for ductal carcinoma in situ, who have had a previous mastectomy, or even after previous benign breast or axillary surgery. To date the literature on SLN biopsy in patients with recurrent breast cancer is scarce: only to publications dealing with 116 patients. It is concluded that a SLN procedure in recurrent disease is feasible and can possibly lead to the identification of specific or aberrant lymphatic drainages. This could then lead to useful changes being made to the multidisciplinary treatment strategy in selected patients following a successful SLN biopsy. Since there are still no proper guidelines for performing such a repeat SLN biopsy, it is necessary to reach consensus on this new indication in the short-term.
前哨淋巴结（SLN）概念已成为原发性浸润性乳腺癌患者诊断和治疗的标准选择。这一SLN概念的实施产生了一类新的患者：那些在SLN活检阴性后接受保乳治疗且未进行完整腋窝淋巴结清扫的患者。在同侧乳房局部复发的情况下，会出现关于这种新肿瘤淋巴引流的问题。对于原位导管癌患者、先前接受过乳房切除术的患者，甚至在先前进行过良性乳房或腋窝手术之后的患者，情况也是如此。迄今为止，关于复发性乳腺癌患者SLN活检的文献很少：仅有两篇涉及116例患者的出版物。得出的结论是，复发性疾病中的SLN程序是可行的，并且可能会识别出特定或异常的淋巴引流。在成功进行SLN活检后，这可能会导致对选定患者的多学科治疗策略做出有益的改变。由于目前仍没有进行这种重复SLN活检的适当指南，因此有必要在短期内就这一新适应症达成共识。
