Nowikiewicz Tomasz, Nowak Adam, Wiśniewska Magdalena, Wiśniewski Michał, Zegarski Wojciech
Department of Breast Cancer and Reconstructive Surgery, Prof. F. Łukaszczyk Oncology Centre, Bydgoszcz, Poland.
Diagnostic Imaging and Interventional Radiology Unit, Prof. F. Łukaszczyk Oncology Centre, Bydgoszcz, Poland.
Wideochir Inne Tech Maloinwazyjne. 2015 Jul;10(2):170-7. doi: 10.5114/wiitm.2015.52264. Epub 2015 Jun 15.
INTRODUCTION: Sentinel lymph node biopsy (SLNB) is a standard procedure in the therapeutic management of patients with non-advanced breast cancer. AIM: To analyse the utility of ultrasound scan (USS) examination in the process of patient qualification for SLNB and to estimate the optimal time to perform USS in the clinical preoperational assessment of axillary lymph nodes. MATERIAL AND METHODS: A prospective analysis of 702 patients with invasive breast cancer treated with SLNB between 7.03.2012 and 27.05.2013 was performed. The patients were divided into three groups: I (USS < 8 weeks before SLNB), II (USS > 8 weeks before SLNB and another one on the day before SLNB) and III (USS > 8 weeks before SLNB without perioperative USS). In these patients the percentage of metastases in the sentinel lymph node and the clinical factors influencing the diagnostic value of preoperative ultrasound scan were assessed. RESULTS: Metastatic lesions in sentinel lymph nodes were found in 154 (21.9%) patients. The highest percentage of metastases was noted in patients operated on in the second and third month from the beginning of preoperative diagnostics. None of the factors tested (size of the original tumour, histological malignancy grading, kind of preoperative diagnostics, Ki-67 value, biological type of the tumour, age) had a statistically significant influence on the diagnostic value of perioperative USS examination in the analysed time span. CONCLUSIONS: The lowest percentage of metastases in the sentinel lymph node was noted in the patients qualified for SLNB who had the ultrasound performed directly before the surgical procedure (not more than 4 weeks before the surgery).
引言:前哨淋巴结活检(SLNB)是治疗非晚期乳腺癌患者的标准程序。 目的:分析超声扫描(USS)检查在患者接受SLNB资格评估过程中的效用,并估计在腋窝淋巴结临床术前评估中进行USS的最佳时间。 材料与方法:对2012年3月7日至2013年5月27日期间接受SLNB治疗的702例浸润性乳腺癌患者进行前瞻性分析。患者分为三组:I组(SLNB前超声检查时间<8周),II组(SLNB前超声检查时间>8周且在SLNB前一天再次进行超声检查)和III组(SLNB前超声检查时间>8周且围手术期未进行超声检查)。评估这些患者前哨淋巴结转移的百分比以及影响术前超声扫描诊断价值的临床因素。 结果:154例(21.9%)患者前哨淋巴结发现转移病变。从术前诊断开始的第二个月和第三个月接受手术的患者中转移率最高。在分析的时间范围内,所测试的任何因素(原发肿瘤大小、组织学恶性分级、术前诊断类型、Ki-67值、肿瘤生物学类型、年龄)对围手术期超声检查的诊断价值均无统计学意义上的显著影响。 结论:在接受SLNB资格评估且在手术前直接进行超声检查(手术前不超过4周)的患者中,前哨淋巴结转移率最低。
Wideochir Inne Tech Maloinwazyjne. 2015-7
J Ultrason. 2013-3
Wideochir Inne Tech Maloinwazyjne. 2013-3
Wideochir Inne Tech Maloinwazyjne. 2013-3