Department of Oncology, Multidisciplinary Breast Centre, University Hospitals Leuven, KU Leuven, Herestraat 49, 3000, Louvain, Belgium.
Breast Unit, San Raffaele Scientific and Research Hospital, Milan, Italy.
Breast Cancer Res Treat. 2018 Apr;168(2):551-557. doi: 10.1007/s10549-017-4611-z. Epub 2017 Dec 12.
Safety of sentinel lymph node (SLN) biopsy for breast cancer during pregnancy is insufficiently explored. We investigated efficacy and local recurrence rate in a large series of pregnant patients.
Women diagnosed with breast cancer who underwent SLN biopsy during pregnancy were identified from the International Network on Cancer, Infertility and Pregnancy, the German Breast Group, and the Cancer and Pregnancy Registry. Chart review was performed to record technique and outcome of SLN biopsy, locoregional and distant recurrence, and survival.
We identified 145 women with clinically N0 disease who underwent SLN during pregnancy. The SLN detection techniques were as follows: Tc-labeled albumin nanocolloid only (n = 96; 66.2%), blue dye only (n = 14; 9.7%), combined technique (n = 15; 10.3%), or unknown (n = 20; 13.8%). Mapping was unsuccessful in one patient (0.7%) and she underwent an axillary lymph node dissection (ALND). Mean number of SLNs was 3.2 (interquartile range 1-3; missing n = 15). Positive SLNs were found in 43 (29.7%) patients and 34 subsequently underwent ALND. After a median follow-up of 48 months (range 1-177), 123 (84.8%) patients were alive and free of disease. Eleven patients experienced a locoregional relapse, including 1 isolated ipsilateral axillary recurrence (0.7%). Eleven (7.6%) patients developed distant metastases, of whom 9 (6.2%) died of breast cancer. No neonatal adverse events related to SLN procedure during pregnancy were reported.
SLN biopsy during pregnancy has a comparably low axillary recurrence rate as in nonpregnant women. Therefore, this method can be considered during pregnancy instead of standard ALND for early-stage, clinically node-negative breast cancer.
妊娠期前哨淋巴结（SLN）活检的安全性尚未得到充分探索。我们在一个大型孕妇系列中研究了其疗效和局部复发率。
从国际癌症、不孕和妊娠网络、德国乳腺小组以及癌症与妊娠登记处确定了在妊娠期间接受 SLN 活检的被诊断为乳腺癌的女性。进行了图表审查，以记录 SLN 活检的技术和结果、局部和远处复发以及生存情况。
我们确定了 145 名临床 N0 疾病且在妊娠期间接受 SLN 的女性。SLN 检测技术如下：Tc 标记白蛋白纳米胶体（n=96；66.2%）、仅蓝色染料（n=14；9.7%）、联合技术（n=15；10.3%）或未知（n=20；13.8%）。一名患者（0.7%）的定位不成功，她接受了腋窝淋巴结清扫术（ALND）。SLN 平均数量为 3.2（四分位间距 1-3；缺失 n=15）。43 名（29.7%）患者发现阳性 SLN，其中 34 名随后接受了 ALND。在中位随访 48 个月（范围 1-177）后，123 名（84.8%）患者存活且无疾病。11 名患者出现局部区域复发，包括 1 例同侧腋窝孤立复发（0.7%）。11 名（7.6%）患者发生远处转移，其中 9 名（6.2%）死于乳腺癌。未报告与妊娠期间 SLN 手术相关的新生儿不良事件。
妊娠期 SLN 活检的腋窝复发率与非妊娠女性相当。因此，对于早期临床淋巴结阴性乳腺癌，可以考虑在妊娠期采用该方法代替标准的 ALND。
