Cambridge Breast Unit, Addenbrooke's Hospital, Cambridge, UK.
Clin Radiol. 2010 May;65(5):373-6. doi: 10.1016/j.crad.2010.01.013. Epub 2010 Mar 21.
The aim of this paper is to guide the radiologist to the most likely location of the sentinel lymph node (SLN).
Patients with invasive breast cancer underwent axillary ultrasound examination. The position and morphological appearances of the lymph nodes were noted and core biopsy (CB) was performed of the largest or most suspicious node. Those patients whose biopsy revealed no evidence of malignancy proceeded to a surgical sentinel lymph node (SLN) biopsy (SLNB) looking for histopathological evidence of previous CB.
Of 121 patients who underwent axillary ultrasound and CB no malignancy was identified in 73, all of whom subsequently underwent SLNB. Histological evidence of CB in the SLN was identified in 47 (64%) patients. The position of all the lymph nodes identified on ultrasound and the 47 patients whose SLNs were identified were drawn on composite diagrams of the axilla. Of the 36 nodes identified as sentinel whose position relative to other nodes could be determined, 29 (81%) represented the lowest node identified in the axilla, four (11%) were the second lowest, and three (8%) were the third lowest node. None of the four patients whose CB was from the fourth lowest node had the CB site identified at subsequent SLNB.
Ultrasound of the axilla should be carried out in a systematic fashion focusing on level I nodes paying particular attention to the lowest one or two lymph nodes.
本文旨在引导放射科医生找到前哨淋巴结（SLN）最有可能的位置。
浸润性乳腺癌患者接受腋窝超声检查。记录淋巴结的位置和形态外观，并对最大或最可疑的淋巴结进行核心活检（CB）。那些活检未发现恶性证据的患者进行手术前哨淋巴结（SLN）活检（SLNB），以寻找之前 CB 的组织病理学证据。
在 121 例行腋窝超声和 CB 的患者中，73 例未发现恶性肿瘤，所有患者随后均行 SLNB。47 例（64%）患者的 SLN 中发现了 CB 的组织学证据。所有在超声上识别的淋巴结的位置和 47 例 SLN 被识别的患者都被绘制在腋窝的复合图上。在确定位置的 36 个被认为是前哨的淋巴结中，29 个（81%）是腋窝中识别到的最低淋巴结，4 个（11%）是第二低的淋巴结，3 个（8%）是第三低的淋巴结。在随后的 SLNB 中，没有一个 CB 来自第四低淋巴结的患者其 CB 部位被识别。
腋窝超声应系统地进行，重点关注 I 水平的淋巴结，特别注意最低的一个或两个淋巴结。
