Mainiero Martha B
Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI 02903, USA.
Radiol Clin North Am. 2010 Sep;48(5):989-97. doi: 10.1016/j.rcl.2010.06.010.
The status of axillary lymph nodes is a key prognostic indicator in patients with breast cancer and helps guide patient management. Sentinel lymph node biopsy is increasingly being used as a less morbid alternative to axillary lymph node dissection. However, when sentinel lymph node biopsy is positive, axillary dissection is typically performed for complete staging and local control. Axillary ultrasound and ultrasound-guided fine needle aspiration (USFNA) are useful for detecting axillary nodal metastasis preoperatively and can spare patients sentinel node biopsy, because those with positive cytology on USFNA can proceed directly to axillary dissection or neoadjuvant chemotherapy. Internal mammary nodes are not routinely evaluated, but when the appearance of these nodes is abnormal on imaging, further treatment or metastatic evaluation may be necessary.
腋窝淋巴结状态是乳腺癌患者关键的预后指标，有助于指导患者的治疗管理。前哨淋巴结活检正越来越多地被用作腋窝淋巴结清扫术的一种创伤较小的替代方法。然而，当前哨淋巴结活检结果为阳性时，通常会进行腋窝清扫以完成分期和局部控制。腋窝超声及超声引导下细针穿刺抽吸术（USFNA）有助于术前检测腋窝淋巴结转移，并且可以使患者免于前哨淋巴结活检，因为USFNA细胞学检查结果为阳性的患者可直接进行腋窝清扫或新辅助化疗。内乳淋巴结通常不进行常规评估，但当这些淋巴结在影像学上表现异常时，可能需要进一步治疗或进行转移评估。
