中国可手术大乳腺癌（≥4cm）患者前哨淋巴结活检：单中心 10 年经验

Sentinel lymph node biopsy in Chinese patients with large operable breast cancer (≥4 cm): A decade's experience from a single institution.

机构信息

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Breast Cancer Prevention & Treatment Center, Peking University Cancer Hospital & Institute, Beijing 100142, China.

出版信息

Breast. 2017 Dec;36:20-24. doi: 10.1016/j.breast.2017.08.007. Epub 2017 Sep 1.

DOI:10.1016/j.breast.2017.08.007

PMID:28869832

Abstract

BACKGROUND

Performing sentinel lymph node biopsy (SLNB) in patients with large operable breast cancer is still controversial. Our aim is to find whether or not performing SLNB is feasible and safety in Chinese patients with large operable breast cancer.

METHODS

We reviewed the data of patients in our center from 2003 to 2015, a series of 267 patients with large operable breast cancer (≥4 cm) who underwent SLNB were examined. All selected patients recieved preoperative axillary evaluation.

RESULTS

The successful rate for localizing SLNs was 96.3% (257 of 267). 31.1% (78 of 257) patients were found to have positive sentinel lymph nodes (SLN). The median follow-up was 52 months. 2.2% (4 of 179) SLN-negative patients developed axillary recurrence (AR) as first event. The 5-year axillary recurrence free survival in SLN-negative patients was 96.9% (95%CI, 93.8%-100%). Patients with suspicious nodes on ultrasonography (US) (P = 0.16) and undergoing breast conserving therapy (BCT) (P = 0.057) had a higher trend to be associated with AR. The 5-year recurrence free survival (RFS) was 86.1% (95%CI, 80.8%-93.0%) in SLN-negative patients and 76.3% (95%CI, 68.1%-90.1%) in SLN-positive patients (P = 0.246).

CONCLUSIONS

SLNB is feasible and safety in patients with large operable breast cancer who underwent preoperative axillary evaluation.

摘要

背景

在可手术的大型乳腺癌患者中进行前哨淋巴结活检（SLNB）仍然存在争议。我们的目的是确定在中国可手术的大型乳腺癌患者中进行 SLNB 是否可行和安全。

方法

我们回顾了 2003 年至 2015 年在我院就诊的患者数据，对 267 例接受 SLNB 的可手术的大型乳腺癌（≥4cm）患者进行了研究。所有入选患者均接受了术前腋窝评估。

结果

SLN 定位成功率为 96.3%（257/267）。78 例（257 例中有 31.1%）患者的前哨淋巴结（SLN）阳性。中位随访时间为 52 个月。4 例（179 例中有 2.2%）SLN 阴性患者作为首发事件发生腋窝复发（AR）。SLN 阴性患者的 5 年腋窝无复发生存率为 96.9%（95%CI，93.8%-100%）。超声（US）检查可疑淋巴结（P=0.16）和接受保乳治疗（BCT）（P=0.057）的患者更倾向于发生 AR。SLN 阴性患者的 5 年无复发生存率（RFS）为 86.1%（95%CI，80.8%-93.0%），SLN 阳性患者为 76.3%（95%CI，68.1%-90.1%）（P=0.246）。