Department of General Surgery, Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey.
J Surg Oncol. 2010 Feb 1;101(2):141-4. doi: 10.1002/jso.21450.
Conventional surgical exploration to find clinically occult axillary lymph node recurrence of breast cancer can be challenging. The aim of this study was to determine the place of our alternative technique, axillary-ROLL (A-ROLL), in previously treated breast cancer patients with nonpalpable axillary lymph node recurrences.
Between March 2005 and May 2009, included in this retrospective study were four women (age, 42-51 years) without clinical evidence of distant metastasis who had treatment for breast cancer and were subsequently found to have suspicious axillary lymph node(s) detected by control ultrasonography (US) examination during follow-up. A-ROLL was utilized for the identification of lymph nodes. 0.5-1 mCi (99m)Tc-human serum albumin makroaggregate was injected under US guidance. A gamma probe was then used to guide the excision of the lymph nodes.
The involved lymph nodes were successfully localized by A-ROLL technique and removed surgically. Of all four patients, postoperative histopathologic examination revealed nodal cancer metastases in three patients (75%) and lymphoid hyperplasia in one patient. No complications occurred.
A-ROLL technique has proved to be accurate and safe in the identification and excision of clinically occult axillary lymph node recurrence.
传统的手术探查对于发现乳腺癌临床隐匿性腋窝淋巴结复发具有挑战性。本研究旨在确定我们的替代技术——腋窝-ROLL（A-ROLL）在既往治疗过的乳腺癌患者中对于触诊阴性腋窝淋巴结复发的应用价值。
本回顾性研究纳入了 4 名年龄在 42-51 岁之间的女性患者，这些患者在接受乳腺癌治疗后，通过随访中的超声检查发现可疑腋窝淋巴结，而无远处转移的临床证据。在超声引导下，将 0.5-1mCi（99m）Tc-人血清白蛋白微球注入。然后使用伽马探针引导切除淋巴结。
A-ROLL 技术成功定位并切除了受累淋巴结。所有 4 名患者中，术后组织病理学检查显示 3 名患者（75%）存在淋巴结转移，1 名患者存在淋巴结增生。未发生并发症。
A-ROLL 技术在识别和切除临床隐匿性腋窝淋巴结复发方面已被证明是准确和安全的。
