Rutgers Emiel J T
Department of Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands.
J Clin Oncol. 2008 Feb 10;26(5):698-702. doi: 10.1200/JCO.2007.14.4667.
The sentinel node procedure is an adequate tool to identify lymph node metastasis in breast cancer. Sentinel nodes are generally examined with greater attention mainly to exclude, as reliably as possible, lymph node metastasis. To achieve this, many protocols are used, resulting in different rates of micrometastasis or isolated tumor cells encountered. Since the prognostic significance of isolated tumor cells or micrometastasis in the sentinel nodes, and the risk of further axillary lymph node involvement in patients with isolated tumor cells, is uncertain and at most limited, these findings may pose difficulties for clinicians in clinical decision making. Protocols that identify lymph node metastasis, from which the clinical relevance is known, are warranted. Unnecessary lymph node dissections should be avoided.
前哨淋巴结活检术是识别乳腺癌淋巴结转移的一种有效手段。通常会更加仔细地检查前哨淋巴结，主要是为了尽可能可靠地排除淋巴结转移。为了达到这一目的，人们采用了多种方案，导致所发现的微转移或孤立肿瘤细胞的比率各不相同。由于前哨淋巴结中孤立肿瘤细胞或微转移的预后意义，以及孤立肿瘤细胞患者进一步发生腋窝淋巴结受累的风险尚不确定且至多有限，这些发现可能会给临床医生的临床决策带来困难。因此，需要有能够识别已知临床相关性的淋巴结转移的方案。应避免不必要的淋巴结清扫。
