Al Ayyan Muna, Bu Ali Omaima, Al Sharri Sheikha, Kassis Adnan, Hussain Sabir, Al-Bashir Mohamed
Department of Surgery, Tawam Hospital, Al-Ain, United Arab Emirates.
Asia Pac J Clin Oncol. 2014 Jun;10(2):e86-9. doi: 10.1111/ajco.12039. Epub 2012 Nov 21.
To evaluate whether axillary ultrasound in combination with a biopsy (AUS +/- Bx) can predict the involvement of the non-sentinel lymph nodes (NSLN).
A review of all operable breast cancer patients who underwent AUS +/- Bx at our tertiary care center from January 2010 to April 2011 was performed. All patients underwent AUS as part of their pre-operative evaluation. If the AUS was suspicious, a fine-needle aspiration or core-needle biopsy was performed.
Of 88 patients included in our final analysis, 20 (23%) had positive AUS + Bx and underwent axillary lymph node dissection (ALND) at time of definitive surgery. In all, 68 of the 88 patients (77.3%) had negative AUS +/- Bx and underwent sentinel lymph node (SLN) Bx at the time of definitive surgery. If the SLN Bx was negative, no further axillary surgery was performed and the NSLN were assumed to be negative. If the SLN Bx was positive, ALND was performed. Of the 68 patients, 62 (91%) had a negative NSLN. Patients with positive AUS + Bx carry a relative risk of 2.02 (P < 0.00002) of having positive NSLN.
In operable breast cancer patients, a negative AUS+/- Bx may be a predictor of non-involvement of the NSLN.
评估腋窝超声联合活检（AUS +/- Bx）能否预测非前哨淋巴结（NSLN）受累情况。
回顾了2010年1月至2011年4月在我们三级医疗中心接受AUS +/- Bx的所有可手术乳腺癌患者。所有患者在术前评估时均接受了AUS检查。如果AUS检查结果可疑，则进行细针穿刺抽吸或粗针活检。
在纳入最终分析的88例患者中，20例（23%）AUS + Bx结果为阳性，并在确定性手术时进行了腋窝淋巴结清扫（ALND）。88例患者中，共有68例（77.3%）AUS +/- Bx结果为阴性，并在确定性手术时进行了前哨淋巴结（SLN）活检。如果SLN活检结果为阴性，则不再进行进一步的腋窝手术，并假定NSLN为阴性。如果SLN活检结果为阳性，则进行ALND。在这68例患者中，62例（91%）的NSLN为阴性。AUS + Bx结果为阳性的患者NSLN阳性的相对风险为2.02（P < 0.00002）。
在可手术乳腺癌患者中，AUS +/- Bx结果为阴性可能是NSLN未受累的一个预测指标。
