Han Chao, Yang Li, Zuo Wenshu
Department of Surgery, Shandong Breast Center of Prevention and Treatment, Shandong Cancer Hospital Affiliated to Shandong University, Shandong Academy of Medical Sciences, Jinan 250117, China.
Chin J Cancer Res. 2016 Jun;28(3):370-6. doi: 10.21147/j.issn.1000-9604.2016.03.12.
Sentinel lymph node biopsy (SLNB) is a new surgical technique for local axillary lymph nodes (ALNs) of breast cancer. Large-scale clinical trials have confirmed that undergoing SLNB and ALN dissection (ALND) showed no significant difference for sentinel lymph node (SLN)-negative patients in terms of disease-free survival, overall survival and recurrence-free survival. However, false-negative results are still the main concern of physicians as well as patients who undergo SLNB instead of ALND. The American Society of Breast Surgeons established a task force to suggest acceptable standards for SLNB. In 2000, the task force recommended that the identification rate for SLNB be 85% or higher and the false-negative rate be 5% or lower. This review focuses on clinical factors (tumor volume, multifocal/multi-center cancers, neoadjuvant chemotherapy and skip metastasis), tracer techniques and pathological factors affecting SLNB and explores methods for reducing the false-negative rate.
前哨淋巴结活检（SLNB）是一种针对乳腺癌腋窝局部淋巴结（ALNs）的新型外科技术。大规模临床试验已证实，对于前哨淋巴结（SLN）阴性的患者，接受SLNB和腋窝淋巴结清扫术（ALND）在无病生存期、总生存期和无复发生存期方面无显著差异。然而，假阴性结果仍是接受SLNB而非ALND的医生和患者主要关注的问题。美国乳腺外科医师协会成立了一个特别工作组，以提出SLNB可接受的标准。2000年，该特别工作组建议SLNB的识别率应为85%或更高，假阴性率应为5%或更低。本综述重点关注影响SLNB的临床因素（肿瘤体积、多灶性/多中心癌、新辅助化疗和跳跃转移）、示踪技术和病理因素，并探索降低假阴性率的方法。
