Maráz Róbert, Boross Gábor, Pap-Szekeres József, Markó László, Rajtár Mária, Ambrózay Éva, Bori Rita, Cserni Gábor
Department of Surgery, Bács-Kiskun County Teaching Hospital, Nyíri út 38, Kecskemet, 6000, Hungary.
Department of Oncology, Bács-Kiskun County Teaching Hospital, Nyíri út 38, Kecskemet, 6000, Hungary.
Breast Cancer. 2016 Jan;23(1):85-91. doi: 10.1007/s12282-014-0535-1. Epub 2014 May 3.
Sentinel lymph node biopsy (SLNB) is a standard procedure in women with breast cancer. The risk of morbidity related to axillary lymph node dissection (ALND) is similar for men and women with breast cancer and SLNB could minimize this risk.
Between January 2004 and August 2013, 25 men with primary breast cancer were operated on at the Bács-Kiskun County Teaching Hospital. These were reviewed retrospectively. SLNB was performed following lymphoscintigraphy with intraoperative gamma probe detection and blue dye mapping.
SLNB was successful in all 16 male patients (100 %), in whom it was attempted. The SLNs were negative in 4 cases (25 %) and were involved in 12. Intraoperative imprint cytology was positive in 9 of the 12 involved cases (75 %) and resulted immediate completion ALND. In 7 patients, the intraoperative imprint cytology was negative, with 3 false-negative results that resulted in delayed completion ALND. After a median follow-up of 48 months, there was only one axillary recurrence after ALND and none in the SLNB group.
SLNB is successful and accurate in male breast cancer patients too. Although compared to women a larger proportion of men have positive nodes, for men with negative nodes, ALND-related morbidity may be reduced by SLNB. We recommend SLNB in male patients with breast cancer and clinically negative axilla.
前哨淋巴结活检(SLNB)是乳腺癌女性患者的标准治疗手段。乳腺癌男性和女性患者发生腋窝淋巴结清扫术(ALND)相关并发症的风险相似,而SLNB可将此风险降至最低。
2004年1月至2013年8月期间,25例原发性乳腺癌男性患者在巴奇-基什孔州教学医院接受了手术治疗。对这些病例进行回顾性分析。在淋巴闪烁显像后,采用术中γ探针探测和蓝色染料定位法进行SLNB。
16例尝试进行SLNB的男性患者全部成功(100%)。前哨淋巴结阴性4例(25%),阳性12例。12例阳性病例中,9例术中印片细胞学检查呈阳性(75%),随即完成ALND。7例患者术中印片细胞学检查呈阴性,其中3例假阴性结果导致延迟完成ALND。中位随访48个月后,ALND组仅出现1例腋窝复发,SLNB组无复发。
SLNB在男性乳腺癌患者中同样成功且准确。虽然与女性相比,男性有更多比例的患者前哨淋巴结呈阳性,但对于前哨淋巴结阴性的男性患者,SLNB可降低ALND相关并发症的发生。我们建议对临床腋窝阴性的男性乳腺癌患者行SLNB。