Tsugawa Koichiro
Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
Nihon Geka Gakkai Zasshi. 2013 Jan;114(1):22-7.
Axillary lymph node status is one of the most important prognostic factors in patients with invasive breast carcinoma. Sentinel lymph node biopsy leads to more accurate examination of the lymph nodes and has resulted in an increased detection rate of small cancer deposits. Patients with micrometastatic foci can have nonsentinel lymph node involvement, including macrometastatic foci. Sentinel lymph node micrometastases are associated with an adverse impact on disease recurrence or survival. Axillary clearance offers no advantage in reducing the incidence of disease recurrence and survival. However, the long-term outcomes can be improved with the use of adjuvant systemic therapy, and it would be reasonable to consider systemic treatment in these patients.
腋窝淋巴结状态是浸润性乳腺癌患者最重要的预后因素之一。前哨淋巴结活检可更准确地检查淋巴结，并提高了微小癌灶的检出率。有微转移灶的患者可能存在非前哨淋巴结受累，包括宏转移灶。前哨淋巴结微转移对疾病复发或生存有不利影响。腋窝清扫在降低疾病复发率和提高生存率方面并无优势。然而，使用辅助性全身治疗可改善长期预后，因此考虑对这些患者进行全身治疗是合理的。
