Gauthier T, Fermeaux V, Mollard J, Aubard Y
Service de gynécologie-obstétrique, hôpital Mère-Enfant, CHU Dupuytren, 87000 Limoges, France.
Gynecol Obstet Fertil. 2009 Jun;37(6):481-7. doi: 10.1016/j.gyobfe.2009.04.012. Epub 2009 May 19.
Because of variability in histopathological interpretations in studies, it's difficult to elucidate the risk of non-sentinel lymph node involvement in case of sentinel node nanometastases (lesions not larger than 0.2 mm) and micrometastases (lesions not larger than 2 mm but larger than 0.2 mm) in breast cancer. In this study, we have evaluated this risk according to the European Working Group for Breast Screening Pathology (EWGBSP) recommendations.
Among patients who underwent sentinel lymph node dissection between February 2001 and April 2008 in our unit, we reviewed the files of patients who had sentinel lymph node involvement smaller than 2mm. A second interpretation of all sentinel lymph node sections was made according to the EWGBSP recommendations. Each patient had complete axillary dissection.
Among 608 patients who had sentinel lymph node dissection for breast cancer, 72 (11.84%) had sentinel lymph node involvement smaller than 2 mm (27 pN0i+ and 45 pN1mi). The percentage of pN1mi patients who had non sentinel involvement is 8.89%. None of pN0i+ patients had non sentinel involvement.
After making a minimal sentinel lymph node involvement strict interpretation according to EWGBSP restrictive recommendations, nanometastases rate was smaller. Any non sentinel involvement was detected in case of sentinel lymph node nanometastases.
由于研究中组织病理学解释存在差异,难以阐明乳腺癌前哨淋巴结微转移(病灶不大于0.2毫米)和微小转移(病灶不大于2毫米但大于0.2毫米)情况下非前哨淋巴结受累的风险。在本研究中,我们根据欧洲乳腺癌筛查病理学工作组(EWGBSP)的建议评估了这一风险。
在2001年2月至2008年4月期间在我们科室接受前哨淋巴结清扫术的患者中,我们回顾了前哨淋巴结受累小于2毫米的患者档案。根据EWGBSP的建议对所有前哨淋巴结切片进行了二次解读。每位患者均进行了完整的腋窝清扫术。
在608例行乳腺癌前哨淋巴结清扫术的患者中,72例(11.84%)前哨淋巴结受累小于2毫米(27例pN0i+和45例pN1mi)。有非前哨淋巴结受累的pN1mi患者的比例为8.89%。pN0i+患者均无非前哨淋巴结受累。
根据EWGBSP的严格建议对前哨淋巴结最小受累情况进行严格解读后,微转移率较低。在前哨淋巴结微转移的情况下未检测到任何非前哨淋巴结受累。