Ogawa Yoshinari, Ikeda Katsumi, Ogisawa Kana, Tokunaga Shinya, Fukushima Hiroko, Inoue Takeshi, Mori Yoshihiro, Tachimori Akiko, Inoue Toru, Nishiguchi Yukio
Department of Breast Surgical Oncology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, 534-0021, Japan,
Surg Today. 2014 Sep;44(9):1633-7. doi: 10.1007/s00595-013-0728-9. Epub 2013 Sep 26.
Various techniques are used for sentinel lymph node biopsy (SLNB) in breast cancer. While subareolar injection with dye alone is a relatively easy method, few studies have reported the outcome with a follow-up period. This study presents our results of SLNB using dye alone.
Between November 2002 and December 2010, 701 patients with breast cancer underwent SLNB using subareolar injection of indocyanine green or indigo carmine. Sentinel lymph node (SLN)-negative patients were followed without axillary lymph node dissection (ALND).
SLNs were detected in 654 of 701 patients (93.3%), and the rate increased to 98.1% over the course of the study. The mean number of SLNs removed was 1.5. There was no significant difference in the detection rate between two dyes. No adverse events resulted from the injection of dyes. Of the 654 patients, 136 (20.8%) had SLN metastasis. Five hundred patients were followed without ALND. Thirty-six patients experienced disease relapse during a median follow-up of 60 months. Thirteen patients (2.6%) had regional lymph node relapse, and eight of them could undergo salvage lymph node dissection. The 5-year disease-free and overall survival rates were 92.4 and 96.1 %, respectively.
SLNB using subareolar injection with dye alone was safe and feasible even after a long follow-up.
乳腺癌前哨淋巴结活检（SLNB）采用多种技术。虽然单纯乳晕下注射染料是一种相对简单的方法，但很少有研究报告随访期的结果。本研究展示了我们单纯使用染料进行SLNB的结果。
2002年11月至2010年12月期间，701例乳腺癌患者接受了乳晕下注射吲哚菁绿或靛胭脂的SLNB。前哨淋巴结（SLN）阴性的患者未进行腋窝淋巴结清扫（ALND）而接受随访。
701例患者中有654例（93.3%）检测到SLN，在研究过程中该比例增至98.1%。切除的SLN平均数量为1.5个。两种染料的检测率无显著差异。注射染料未导致不良事件。654例患者中，136例（20.8%）发生SLN转移。500例患者未进行ALND而接受随访。在中位随访60个月期间，36例患者出现疾病复发。13例患者（2.6%）发生区域淋巴结复发，其中8例可接受挽救性淋巴结清扫。5年无病生存率和总生存率分别为92.4%和96.1%。
即使经过长期随访，单纯乳晕下注射染料进行SLNB也是安全可行的。
