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早期乳腺癌患者的前哨淋巴结活检应该被放弃吗?没那么快。

Should Sentinel Lymph Node Biopsy for Patients with Early Breast Cancer Be Abandoned? Not So Fast.

作者信息

Chu Quyen D, Peddi Prakash

机构信息

Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, LA, USA.; Professor and Chief of Surgical Oncology Charles D. Knight, Sr. Endowed Professor of Surgery Director, Vice-Chair of Academic Affairs, Peritoneal Surface Malignancies Program, Feist-Weiller Cancer Center, LSU-Health Sciences Center-Shreveport, Shreveport, LA, USA.

Department of Medicine, The Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center, Shreveport, LA, USA.; Assistant Professor of Medicine, Division of Hematology and Oncology, Feist-Weiller Cancer Center, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA, USA.

出版信息

Clin Med Insights Oncol. 2016 Jul 5;10:67-9. doi: 10.4137/CMO.S32817. eCollection 2016.

DOI:10.4137/CMO.S32817
PMID:27398043
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4934171/
Abstract

As major advances are made in the management of early breast cancer, the role of sentinel lymph node biopsy (SLNBx) has been called into question. However, before abandoning SLNBx, a critical appraisal of its role should be done because we believe that it remains a critical component of care, especially when tailoring patient's adjuvant therapy. This commentary provides cogent arguments in favor of SLNBx in the management of patients with early breast cancer.

摘要

随着早期乳腺癌治疗取得重大进展,前哨淋巴结活检(SLNBx)的作用受到了质疑。然而,在放弃前哨淋巴结活检之前,应对其作用进行批判性评估,因为我们认为它仍然是治疗的关键组成部分,尤其是在为患者量身定制辅助治疗时。本评论提供了令人信服的论据,支持在前哨淋巴结活检在早期乳腺癌患者的治疗中应用。

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本文引用的文献

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Prospective Validation of a 21-Gene Expression Assay in Breast Cancer.21基因表达检测法在乳腺癌中的前瞻性验证
N Engl J Med. 2015 Nov 19;373(21):2005-14. doi: 10.1056/NEJMoa1510764. Epub 2015 Sep 27.
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Staging the Axilla in Early Breast Cancer: Will Imaging Replace Surgery?早期乳腺癌腋窝分期:影像学检查能否取代手术?
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Long-Term Follow-Up of the E1199 Phase III Trial Evaluating the Role of Taxane and Schedule in Operable Breast Cancer.评估紫杉烷及给药方案在可手术乳腺癌中作用的E1199Ⅲ期试验的长期随访
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Adjuvant paclitaxel and trastuzumab for node-negative, HER2-positive breast cancer.辅助性紫杉醇和曲妥珠单抗用于HER2阳性、淋巴结阴性乳腺癌的治疗
N Engl J Med. 2015 Jan 8;372(2):134-41. doi: 10.1056/NEJMoa1406281.
5
Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial.乳腺癌前哨淋巴结阳性后腋窝的放疗或手术(EORTC 10981-22023 AMAROS):一项随机、多中心、开放标签的3期非劣效性试验。
Lancet Oncol. 2014 Nov;15(12):1303-10. doi: 10.1016/S1470-2045(14)70460-7. Epub 2014 Oct 15.
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Sentinel lymph node surgery after neoadjuvant chemotherapy in patients with node-positive breast cancer: the ACOSOG Z1071 (Alliance) clinical trial.新辅助化疗后前哨淋巴结阳性乳腺癌患者的前哨淋巴结手术:ACOSOG Z1071(Alliance)临床试验。
JAMA. 2013 Oct 9;310(14):1455-61. doi: 10.1001/jama.2013.278932.
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Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: a systematic review and meta-analysis.术前超声引导下腋窝淋巴结活检对预防乳腺癌腋窝淋巴结清扫术的价值:一项系统评价和荟萃分析
Ann Surg Oncol. 2014 Jan;21(1):51-9. doi: 10.1245/s10434-013-3229-6. Epub 2013 Sep 6.
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Lancet Oncol. 2013 Jun;14(7):609-18. doi: 10.1016/S1470-2045(13)70166-9. Epub 2013 May 15.
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Breast Cancer Res Treat. 2012 Aug;134(3):903-13. doi: 10.1007/s10549-011-1933-0. Epub 2012 Jan 24.
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Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials.不同化疗方案治疗早期乳腺癌的比较:123 项随机试验 10 万名女性长期结局的荟萃分析。
Lancet. 2012 Feb 4;379(9814):432-44. doi: 10.1016/S0140-6736(11)61625-5. Epub 2011 Dec 5.