Mátrai Zoltán, Tóth László, Polgár Csaba, Láng István, Gõdény Mária, Sinkovics István, Horváth Zsolt, Bidlek Mária, Udvarhelyi Nóra, Bartal Alexandra, Sávolt Akos, Ujhelyi Mihály, Kásler Miklós
Általános és Mellkassebészeti Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
Magy Onkol. 2011 Jun;55(2):73-84. Epub 2011 Feb 2.
The indication of neoadjuvant chemotherapy has been recently extended; it is now applied not only in locally advanced breast cancer but in primarily resecable tumours as well, in order to promote breast conservation. Based on recent clinical results, the reconsideration of traditional lymph node dissection in axillary staging is timely in patients receiving neoadjuvant chemotherapy. Precise axillary staging needs surgical removal of lymph nodes. Based on prospective randomised trials, sentinel lymph node biopsy appears to be appropriate for axillary staging even in tumours requiring neoadjuvant treatment. The extended indication of sentinel lymph node biopsy raises several questions and problems. In the present paper the authors review the results and possible limitations of sentinel lymph node biopsy in relation to neoadjuvant chemotherapy.
新辅助化疗的适应证最近有所扩大；目前不仅应用于局部晚期乳腺癌，也应用于原本可切除的肿瘤，以促进保乳。基于近期的临床结果，对于接受新辅助化疗的患者，适时重新考虑腋窝分期中传统淋巴结清扫术是必要的。精确的腋窝分期需要手术切除淋巴结。基于前瞻性随机试验，前哨淋巴结活检即使在需要新辅助治疗的肿瘤中似乎也适用于腋窝分期。前哨淋巴结活检适应证的扩大引发了一些问题。在本文中，作者回顾了与新辅助化疗相关的前哨淋巴结活检的结果及可能的局限性。
