Beumer Jesse D, Gill Grantley, Campbell Ian, Wetzig Neil, Ung Owen, Farshid Gelareh, Uren Roger, Stockler Martin, Gebski Val
Royal Adelaide Hospital, Adelaide, South Australia, Australia; University of Adelaide, Adelaide, South Australia, Australia.
ANZ J Surg. 2014 Mar;84(3):117-20. doi: 10.1111/ans.12139. Epub 2013 Apr 18.
Sentinel node biopsy is an accurate method for staging the axilla in early (small) breast cancers. However, data for the role of this technique for large breast cancers remain limited.
From the Royal Adelaide Hospital Sentinel Node database and the SNAC trial database, 100 subjects were identified with clinically node negative, large (≥3 cm) primary breast cancer who had undergone sentinel node biopsy and immediate axillary clearance. The pathology results from the sentinel node and axillary specimens were analysed.
Average tumour size was 3.91 cm (range 3-10 cm) and 65 of 100 cases had metastatic disease in the axillary nodes. A sentinel node was successfully identified in 93 out of 100 cases with an average of 1.75 sentinel nodes sampled. Sixty-two per cent (58 out of 93) were sentinel node positive and 43% (43 out of 100) had a positive non-sentinel node. The false negative rate following successful sentinel node identification was 4.9% (3 out of 61).
Sentinel node biopsy was an accurate tool for staging the axilla with a false negative rate comparable to that seen in small tumours. However, given the increased incidence of metastases with larger cancers, further prospective investigation is warranted.
前哨淋巴结活检是早期（小）乳腺癌腋窝分期的一种准确方法。然而，该技术在大乳腺癌中的作用的数据仍然有限。
从皇家阿德莱德医院前哨淋巴结数据库和SNAC试验数据库中，识别出100例临床腋窝淋巴结阴性、原发性大乳腺癌（≥3 cm）且已接受前哨淋巴结活检和即刻腋窝清扫的患者。分析前哨淋巴结和腋窝标本的病理结果。
平均肿瘤大小为3.91 cm（范围3 - 10 cm），100例中有65例腋窝淋巴结有转移。100例中有93例成功识别出前哨淋巴结，平均取样1.75个前哨淋巴结。62%（93例中的58例）前哨淋巴结阳性，43%（100例中的43例）有非前哨淋巴结阳性。成功识别前哨淋巴结后的假阴性率为4.9%（61例中的3例）。
前哨淋巴结活检是腋窝分期的一种准确工具，其假阴性率与小肿瘤相似。然而，鉴于较大肿瘤转移发生率增加，有必要进行进一步的前瞻性研究。
