Gannan Emma, Khoo Jeremy, Nightingale Sophie, Suhardja Thomas Surya, Lippey Jocelyn, Keane Holly, Tan Kian Jin, Clouston David, Gorelik Alexandra, Mann Gregory Bruce
The Breast Service, The Royal Melbourne Hospital & The Royal Women's Hospital, Parkville, Victoria, Australia.
Department of Surgery, The Royal Melbourne Hospital, Parkville, Victoria, Australia.
Breast J. 2016 Jul;22(4):413-9. doi: 10.1111/tbj.12595. Epub 2016 Apr 20.
To examine practice patterns for breast cancer patients with limited sentinel node (SN) disease in light of the ACOSOG Z0011 results. Retrospective analysis of patients with T1-2 breast cancer and positive sentinel lymph node biopsy (SLNB) admitted between January 2009 and December 2012. Patient demographics, tumor characteristics, and treatments were recorded. Eight hundred positive SLNBs were identified. A total of 452 (56.5%) proceeded to completion axillary lymph node dissection (cALND). cALND rate decreased from 65.1% to 49.7% from 2009-2010 to 2011-2012. cALND was performed for micrometastasis or isolated tumor cells in 39.3% in 2009-2010 and 22.2% in 2011-2012, whereas for macrometastases the rates were 83.1% and 68.6%, respectively. cALND rates diminished for both Z0011-eligible and -ineligible patients. The ACOSOG Z0011 trial presentation and publication coincided with a reduction in cALND for breast cancer with limited nodal disease. There appears equipoise regarding management of macrometastatic SN disease.
根据美国外科医师学会肿瘤学组（ACOSOG）Z0011试验结果，研究前哨淋巴结（SN）疾病有限的乳腺癌患者的治疗模式。对2009年1月至2012年12月期间收治的T1-2期乳腺癌且前哨淋巴结活检（SLNB）阳性的患者进行回顾性分析。记录患者的人口统计学信息、肿瘤特征和治疗情况。共识别出800例SLNB阳性病例。其中452例（56.5%）进行了腋窝淋巴结清扫术（cALND）。2009 - 2010年至2011 - 2012年，cALND率从65.1%降至49.7%。2009 - 2010年，39.3%的患者因微转移或孤立肿瘤细胞进行了cALND，2011 - 2012年这一比例为22.2%；而对于宏转移患者，相应比例分别为83.1%和68.6%。符合和不符合ACOSOG Z0011标准的患者cALND率均下降。ACOSOG Z0011试验的报告和发表恰逢淋巴结疾病有限的乳腺癌患者cALND率降低。对于宏转移SN疾病的管理似乎存在平衡。
