乳腺癌的导管原位癌和前哨淋巴结转移。
Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer.
机构信息
Department of Breast Surgery, Cancer Institute Hospital, Tokyo, Japan.
出版信息
World J Surg Oncol. 2010 Jan 27;8:6. doi: 10.1186/1477-7819-8-6.
Abstract
BACKGROUND
The impact of sentinel lymph node biopsy on breast cancer mimicking ductal carcinoma in situ (DCIS) is a matter of debate.
METHODS
We studied the rate of occurrence of sentinel lymph node metastasis in 255 breast cancer patients with pure DCIS showing no invasive components on routine pathological examination. We compared this to the rate of occurrence in 177 patients with predominant intraductal-component (IDC) breast cancers containing invasive foci equal to or less than 0.5 cm in size.
RESULTS
Most of the clinical and pathological baseline characteristics were the same between the two groups. However, peritumoral lymphatic permeation occurred less often in the pure DCIS group than in the IDC-predominant invasive-lesion group (1.2% vs. 6.8%, p = 0.002). One patient (0.39%) with pure DCIS had two sentinel lymph nodes positive for metastasis. This rate was significantly lower than that in patients with IDC-predominant invasive lesions (6.2%; p < 0.001).
CONCLUSIONS
Because the rate of sentinel lymph node metastasis in pure DCIS is very low, sentinel lymph node biopsy can safely be omitted.
摘要
背景
前哨淋巴结活检对乳腺癌模拟导管原位癌（DCIS）的影响存在争议。
方法
我们研究了 255 例纯 DCIS 乳腺癌患者中前哨淋巴结转移的发生率，这些患者在常规病理检查中没有浸润成分。我们将其与 177 例主要为导管内成分（IDC）乳腺癌患者的发生率进行了比较，这些患者中浸润灶大小等于或小于 0.5cm。
结果
两组的大多数临床和病理基线特征相同。然而，在纯 DCIS 组中，肿瘤周围淋巴管浸润的发生率低于 IDC 优势浸润性病变组（1.2%对 6.8%，p = 0.002）。1 例（0.39%）纯 DCIS 患者有 2 个前哨淋巴结转移阳性。这一比率明显低于 IDC 优势浸润性病变患者（6.2%；p<0.001）。
结论
由于纯 DCIS 前哨淋巴结转移率非常低，因此可以安全地省略前哨淋巴结活检。
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