Department of Surgery, University of Texas Medical Branch, Galveston, TX 77555, USA.
Surgery. 2012 Sep;152(3):389-96. doi: 10.1016/j.surg.2012.06.017.
Multifocal and multicentric breast cancers have been regarded as relative contraindications for sentinel lymph node (SLN) biopsy, because initial validation studies noted an association with greater false-negative rates. The purpose of this study is to perform a meta-analysis of the literature evaluating the feasibility and accuracy of SLN biopsy in multifocal and multicentric breast cancer.
A PubMed search retrieved original articles published between 2000 and 2010 in which the authors evaluated the accuracy of SLN biopsy in multifocal and multicentric breast cancer. Sixteen original articles were included in our meta-analysis.
Nine-hundred thirty-two patients with multifocal and multicentric breast cancer underwent SLN biopsy followed by axillary lymph node dissection. The overall accuracy rate and false-negative rate are 96% and 7.7%, respectively. Of the 37 false-negative biopsies, 7 patients had an additional relative contraindication for SLN biopsy. If we exclude these patients with additional known relative contraindication to SLN biopsy, the accuracy and false-negative rates are 96.7% and 6.3%, respectively.
When a multifocal or multicentric breast cancer has an additional relative contraindication to performing SLN biopsy, such as neoadjuvant chemotherapy or T > 5 cm, the false-negative rate increases.
多灶性和多中心乳腺癌被认为是前哨淋巴结（SLN）活检的相对禁忌证，因为最初的验证研究表明与更高的假阴性率相关。本研究的目的是对评估 SLN 活检在多灶性和多中心乳腺癌中的可行性和准确性的文献进行荟萃分析。
通过 PubMed 检索 2000 年至 2010 年间发表的评估多灶性和多中心乳腺癌 SLN 活检准确性的原始文章。我们的荟萃分析纳入了 16 篇原始文章。
932 例多灶性和多中心乳腺癌患者接受了 SLN 活检和腋窝淋巴结清扫。总体准确率和假阴性率分别为 96%和 7.7%。在 37 例假阴性活检中，7 例患者存在 SLN 活检的额外相对禁忌证。如果我们排除这些存在额外已知 SLN 活检相对禁忌证的患者，准确率和假阴性率分别为 96.7%和 6.3%。
当多灶性或多中心乳腺癌存在 SLN 活检的额外相对禁忌证，如新辅助化疗或 T>5cm 时，假阴性率会增加。
