Cody H S
The Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York 10021, USA.
Breast Cancer. 1999;6(1):13-22. doi: 10.1007/BF02966901.
Sentinel lymph node (SLN) biopsy is a rapidly emerging treatment option for the patient with early stage invasive breast cancer and a clinically negative axilla. In the era of mammographic detection, SLN biopsy has the potential to eliminate axillary dissection for the enlarging cohort of breast cancer patients who are node-negative. With experience, using radioisotope, blue dye, or both, SLN are successfully localized in more than 90% of cases. The effects of isotope and blue dye may be additive. The SLN reliably predicts axillary node status in 98% of all patients, and 95% of those who are node-positive. The operation is best learned under a formalized protocol in which a backup axillary dissection is performed to validate the technique during one's early experience. Enhanced pathologic analysis, including serial sections and immunohistochemical staining, is an essential element of the procedure. In experienced hands, SLN biopsy has less morbidity and greater accuracy than conventional axillary dissection.
前哨淋巴结（SLN）活检是早期浸润性乳腺癌且腋窝临床阴性患者迅速兴起的一种治疗选择。在乳腺钼靶检测时代，SLN活检有可能为越来越多的腋窝淋巴结阴性乳腺癌患者免除腋窝清扫术。随着经验的积累，使用放射性同位素、蓝色染料或两者结合，在超过90%的病例中能成功定位前哨淋巴结。同位素和蓝色染料的作用可能是相加的。前哨淋巴结能可靠地预测所有患者中98%以及淋巴结阳性患者中95%的腋窝淋巴结状态。该手术最好在正式方案下学习，在早期经验阶段进行备用腋窝清扫术以验证技术。强化病理分析，包括连续切片和免疫组化染色，是该手术的重要组成部分。在经验丰富的医生手中，前哨淋巴结活检比传统腋窝清扫术的发病率更低且准确性更高。
