Medical Oncology Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru; Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
Research Department, Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru.
Crit Rev Oncol Hematol. 2018 Sep;129:146-152. doi: 10.1016/j.critrevonc.2018.06.013. Epub 2018 Jun 23.
Around 2% of early breast cancer cases treated with axillary lymph node dissection (ALND) underwent axillary recurrence (AR) and it has a deleterious effect in prognosis. Different scenarios have incorporated Sentinel Lymph Node (SLN) Biopsy (SLNB) instead of ALND as part of the standard treatment and more effective systemic treatment has also been incorporated in routine management after first curative surgery and after regional recurrence. However, there is concern about the effect of SLNB alone over AR risk and how to predict and treat AR. SLN biopsy (SLNB) has been largely accepted as a valid option for SLN-negative cases, and recent prospective studies have demonstrated that it is also safe for some SLN-positive cases and both scenarios carry low AR rates. Different studies have identified clinicopathological factors related to aggressiveness as well as high-risk molecular signatures can predict the development of locoregional recurrence. Other publications have evaluated factors affecting prognosis after AR and find that time between initial treatment and AR as well as tumor aggressive behavior influence patient survival. Retrospective and prospective studies indicate that treatment of AR should include local and systemic treatment for a limited time.
约 2%接受腋窝淋巴结清扫术 (ALND) 治疗的早期乳腺癌病例发生腋窝复发 (AR)，这对预后有不良影响。不同的情况下，已经采用前哨淋巴结活检 (SLN) 代替 ALND 作为标准治疗的一部分，并且在首次治愈性手术后和区域复发后，更有效的系统治疗也已纳入常规管理。然而，人们担心 SLNB 单独对 AR 风险的影响，以及如何预测和治疗 AR。SLN 活检 (SLNB) 已被广泛接受为 SLN 阴性病例的有效选择，最近的前瞻性研究表明，它对某些 SLN 阳性病例也是安全的，这两种情况的 AR 发生率均较低。不同的研究已经确定了与侵袭性相关的临床病理因素以及高风险的分子特征可以预测局部区域复发的发展。其他出版物评估了影响 AR 后预后的因素，发现初始治疗和 AR 之间的时间以及肿瘤侵袭性行为影响患者的生存。回顾性和前瞻性研究表明，AR 的治疗应包括局部和全身治疗，持续时间有限。
