Oregon Health & Science University, Department of Surgery, 3181 SW Sam Jackson Park Rd, Portland, 97239, OR, USA.
Legacy Cancer Institute, Legacy Medical Group Surgical Oncology, 1040 NW 22nd Ave, Suite 560, Portland, 97227, OR, USA.
Am J Surg. 2020 May;219(5):851-854. doi: 10.1016/j.amjsurg.2020.03.012. Epub 2020 Mar 10.
After neoadjuvant chemotherapy (NAC) for clinically node-positive breast cancer (NPBC), targeted axillary dissection (TAD) reduces the false negative rate (FNR) of axillary node sampling. Axillary lymph node dissection (ALND) is indicated if the clipped node cannot be identified. Prior studies have indicated that a sentinel lymph node harvest (SLNH) of ≥3 also leads to low FNR. We investigated the performance of SLNH thresholds at inferring the status of the axilla during TAD.
Retrospective review of the Legacy Health System Tumor Registry was performed. We identified NPBC patients between 2011 and 2016 managed with NAC and TAD.
In 29 patients, the FNR of the SLNB component of TAD was 11% with SLNH of ≥3; with SLNH of ≤2 nodes the FNR was 20%.
In patients with NPBC receiving NAC, adequate SLNH is associated with acceptably low FNR. The decision to pursue ALND for clip identification should be made on a case-by-case basis.
在临床淋巴结阳性乳腺癌（NPBC）接受新辅助化疗（NAC）后，靶向腋窝解剖（TAD）降低了腋窝淋巴结取样的假阴性率（FNR）。如果无法识别夹闭的淋巴结，则需要进行腋窝淋巴结清扫术（ALND）。先前的研究表明，≥3 个前哨淋巴结活检（SLNH）也可导致低 FNR。我们研究了 SLNH 阈值在 TAD 期间推断腋窝状态的性能。
对 Legacy Health 系统肿瘤登记处进行回顾性审查。我们确定了 2011 年至 2016 年期间接受 NAC 和 TAD 治疗的 NPBC 患者。
在 29 名患者中，TAD 的 SLNB 成分的 FNR 为 11%，SLNH ≥3；而 SLNH ≤2 个节点的 FNR 为 20%。
在接受 NAC 的 NPBC 患者中，足够的 SLNH 与可接受的低 FNR 相关。对于夹取物的识别，应根据具体情况决定是否进行 ALND。
