Nowikiewicz Tomasz, Kurylcio Andrzej, Polkowski Wojciech, Zegarski Wojciech
Department of Clinical Breast Cancer and Reconstructive Surgery, The Franciszek Łukaszczyk Oncology Center, Bydgoszcz, Poland.
Department of Surgical Oncology, Medical University of Lublin, Poland.
Prz Menopauzalny. 2016 Mar;15(1):52-5. doi: 10.5114/pm.2016.58775. Epub 2016 Mar 29.
Breast cancer is the most common malignancy in women in well-developed countries. Despite a constant increase in its incidence, the percentage of patients diagnosed with the disease in the non-invasive stage is also rising. This allows more frequently for the use of breast-preserving surgical techniques, involving the breast and the regional lymphatic system. According to current guidelines of expert panels and research societies, the recommended method of identifying the sentinel lymph node is the use of an isotope marker with a dye (a combined isotope and dye method). Cooperation with a nuclear medicine unit is essential (performing a preoperative lymphoscintigraphic scan to identify the lymphatic drainage basin and sentinel lymph node). In the case of smaller centers treating breast cancer, it can be associated with a number of difficulties, including organizational ones, and also increasing general treatment costs. A possible solution to these problems is to use alternative techniques of visualizing the sentinel lymph node, which do not require a radiotracer. In this paper we discuss the currently available methods of mapping the lymphatic system of the axillary region in patients with early breast cancer. The review is limited to reporting on methods of proven (based on clinical research) high diagnostic value.
在发达国家,乳腺癌是女性中最常见的恶性肿瘤。尽管其发病率持续上升,但非浸润性阶段被诊断出患有该疾病的患者比例也在增加。这使得保乳手术技术(涉及乳房和区域淋巴系统)的使用更为频繁。根据专家小组和研究协会的现行指南,推荐的前哨淋巴结识别方法是使用带有染料的同位素标记物(同位素与染料联合法)。与核医学科室合作至关重要(进行术前淋巴闪烁扫描以识别淋巴引流区和前哨淋巴结)。对于治疗乳腺癌的较小中心而言,这可能会带来诸多困难,包括组织方面的困难,同时还会增加总体治疗成本。解决这些问题的一个可能办法是使用无需放射性示踪剂的前哨淋巴结可视化替代技术。在本文中,我们讨论了目前可用于绘制早期乳腺癌患者腋窝区域淋巴系统的方法。本综述仅限于报道经临床研究证实具有高诊断价值的方法。