Britton P D, Provenzano E, Barter S, Gaskarth M, Goud A, Moyle P, Sinnatamby R, Wallis M, Benson J R, Forouhi P, Wishart G C
Department of Radiology, Addenbrooke's Hospital, Cambridge Breast Unit, Cambridge, UK.
Breast. 2009 Feb;18(1):13-6. doi: 10.1016/j.breast.2008.09.003. Epub 2008 Nov 7.
Patients with breast cancer now frequently undergo axillary ultrasound and core biopsy (CB) in an attempt to reduce the number of unnecessary sentinel lymph node (SLN) biopsies. This study aimed to establish the frequency of successful targeting of the SLN by ultrasound guided biopsy. A total of 137 patients had axillary ultrasound of which 121 underwent CB. 73 (60%) patients proceeded to SLN after negative CB. All SLNs were examined for evidence of metastases and previous CB. Of the 73 patients, 51 had no evidence of malignancy in the SLN (true negative=70%). However nodal deposits were found in the remaining 22 patients, representing a false negative rate for CB of 30%. Overall histopathological evidence of previous CB was identified in 47 (64%) of 73 patients undergoing SLN biopsy. The reason for false negative findings in the 22 (30%) patients was failure to sample the sentinel lymph node in 10 (45%) and failure to sample the metastatic disease in the sentinel node in 11 (55%). This study suggests that both better methods of identifying the sentinel lymph node and more adequate sampling are required.
乳腺癌患者目前经常接受腋窝超声检查和粗针活检（CB），以试图减少不必要的前哨淋巴结（SLN）活检数量。本研究旨在确定超声引导活检成功靶向SLN的频率。共有137例患者接受了腋窝超声检查，其中121例接受了CB。CB结果为阴性后，73例（60%）患者进行了SLN活检。所有SLN均接受转移证据和既往CB检查。在这73例患者中，51例SLN无恶性证据（真阴性=70%）。然而，其余22例患者发现有淋巴结转移，CB的假阴性率为30%。在接受SLN活检的73例患者中，47例（64%）有既往CB的总体组织病理学证据。22例（30%）患者出现假阴性结果的原因是，10例（45%）未能对前哨淋巴结进行采样，11例（55%）未能对前哨淋巴结中的转移病灶进行采样。本研究表明，需要更好的前哨淋巴结识别方法和更充分的采样。
