Department of Surgery, Mayo Clinic, Rochester, MN 55905, USA.
Am J Surg. 2012 Feb;203(2):151-5. doi: 10.1016/j.amjsurg.2011.01.030. Epub 2011 Jul 23.
We hypothesized that even in the face of a positive intramammary lymph node (IMLN) a negative axillary sentinel lymph node (SLN) reliably stages the axilla and complete axillary lymph node dissection (CALND) can be avoided.
A literature search identified 386 publications that included IMLNs and SLN biopsies. Patients with a positive IMLN and negative axillary SLN who underwent a CALND were included. A review of our database was also performed.
Twenty-one cases in the literature met our criteria. A review of our database resulted in 2 additional cases. Twenty-three patients were identified who had a positive IMLN, negative axillary SLN biopsy, and underwent a CALND. In all cases, the CALND was negative.
An axillary SLN biopsy accurately represents the disease status of the axilla in cases with a positive IMLN. CALND can be avoided in the setting of a positive IMLN and a negative axillary SLN biopsy.
我们假设，即使在乳腺内淋巴结（IMLN）阳性的情况下，腋窝前哨淋巴结（SLN）阴性也能可靠地分期腋窝，并且可以避免完全腋窝淋巴结清扫术（CALND）。
文献检索确定了 386 篇包含 IMLN 和 SLN 活检的出版物。纳入了 IMLN 阳性和腋窝 SLN 阴性但接受 CALND 的患者。我们还对数据库进行了回顾。
文献中有 21 例符合我们的标准。对我们数据库的回顾又发现了另外 2 例。共确定了 23 例 IMLN 阳性、腋窝 SLN 活检阴性且接受 CALND 的患者。在所有病例中，CALND 均为阴性。
在 IMLN 阳性的情况下，腋窝 SLN 活检能准确代表腋窝的疾病状态。在 IMLN 阳性和腋窝 SLN 活检阴性的情况下，可以避免 CALND。
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