Saitama Cancer Center, Komuro Ina, Kita-Adachi, Japan.
Breast Cancer. 2010;17(1):9-16. doi: 10.1007/s12282-009-0154-4. Epub 2009 Aug 22.
It is currently unclear which patients with breast cancer with sentinel lymph node (SLN) metastases do not need axillary lymph node dissection (ALND).
A cohort of 1,132 women who had unilateral invasive breast cancer with clinically negative nodes or nodes suspicious for metastasis, were intraoperatively diagnosed as having negative SLNs, and did not undergo an immediate ALND. Our intraoperative histological investigation uses H&E staining of a frozen section from a maximum cut surface of each SLN. Of these 1,132 women, 132 (11.7%) were postoperatively diagnosed as having positive SLNs, which classifies them as having an intraoperative, false-negative SLN biopsy (SLNB). Patient and tumor characteristics, treatment methods, and the prognoses of these patients were investigated and compared with the remaining 1,000 patients who were negative for SLNB.
Of the 132 patients with intraoperative, false-negative SLNB, none underwent a further ALND. With a median follow-up period of 58.1 months, none of these patients exhibited recurrence in the axillary nodes. Their recurrence-free survival rates were not statistically different from those of patients with negative SLNB.
ALND can be avoided in most patients with breast cancer with intraoperative, false-negative SLNB.
目前尚不清楚哪些前哨淋巴结（SLN）转移的乳腺癌患者不需要进行腋窝淋巴结清扫术（ALND）。
我们对 1132 例单侧浸润性乳腺癌伴临床阴性淋巴结或疑似转移淋巴结的女性进行了研究，这些患者术中诊断为 SLN 阴性，且未立即进行 ALND。我们的术中组织学研究使用 H&E 染色对每个 SLN 的最大切面进行冷冻切片检查。在这 1132 例女性中，有 132 例（11.7%）术后诊断为 SLN 阳性，这将其归类为术中假阴性 SLN 活检（SLNB）。我们对这些患者的患者和肿瘤特征、治疗方法以及预后进行了调查，并与其余 1000 例 SLNB 阴性的患者进行了比较。
在 132 例术中假阴性 SLNB 患者中，均未进行进一步的 ALND。中位随访 58.1 个月，这些患者的腋窝淋巴结均无复发。他们的无复发生存率与 SLNB 阴性患者无统计学差异。
对于大多数术中假阴性 SLNB 的乳腺癌患者，可以避免进行 ALND。
