腋窝清扫术。前哨淋巴结阳性乳腺癌患者行腋窝清扫术的单中心经验。
Axillary Dissection . no Axillary Dissection in Breast Cancer Patients With Positive Sentinel Lymph Node: A Single Institution Experience.
机构信息
Department of Surgical Sciences, Sant'Anna Hospital, Turin, Italy.
Gynecology and Obstetrics 1, Department of Surgical Sciences, University of Turin, Turin, Italy.
出版信息
In Vivo. 2019 Nov-Dec;33(6):1941-1947. doi: 10.21873/invivo.11689.
Abstract
BACKGROUND/AIM: Axillary surgery of breast cancer patients is undergoing a paradigm shift, as axillary lymph node dissection's (ALND) usefulness is being questioned in the treatment of patients with tumor-positive sentinel lymph node biopsy (SLNB). The aim of this study was to investigate the overall survival (OS) and relapse-free survival (RFS) of patients with positive SLNB treated with ALND or not.
PATIENTS AND METHODS
We investigated 617 consecutive patients with cN0 operable breast cancer with positive SLNB undergoing mastectomy or conservative surgery. A total of 406 patients underwent ALND and 211 were managed expectantly.
RESULTS
No significant difference in OS and RFS was found between the two groups. The incidence of loco-regional recurrence in the SLNB-only group and the ALND group was low and not significant.
CONCLUSION
The type of breast cancer surgery and the omission of ALND does not improve OS or RSF rate in cases with metastatic SLN.
摘要
背景/目的：随着腋窝淋巴结清扫术（ALND）在治疗前哨淋巴结活检阳性的乳腺癌患者中的作用受到质疑，乳腺癌患者的腋窝手术正在发生范式转变。本研究旨在探讨接受 ALND 或未接受 ALND 的前哨淋巴结活检阳性患者的总生存率（OS）和无复发生存率（RFS）。
患者和方法
我们调查了 617 例连续的 cN0 可手术乳腺癌伴前哨淋巴结活检阳性患者，均行乳房切除术或保乳手术。其中 406 例行 ALND，211 例采用期待治疗。
结果
两组间 OS 和 RFS 无显著差异。SLNB 组和 ALND 组局部区域复发的发生率较低且无显著性差异。
结论
对于转移性 SLN 患者，乳腺癌手术类型和省略 ALND 并不能提高 OS 或 RFS 率。
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