Department of Surgery, Mazandaran University of Medical Sciences, Sari, Iran.
Department of Breast Surgery, Iran University of Medical Sciences, Tehran, Iran.
Asian Pac J Cancer Prev. 2020 Jun 1;21(6):1631-1636. doi: 10.31557/APJCP.2020.21.6.1631.
Sentinel lymph node biopsy is a reliable method for evaluation of the axillary lymph node status in early stage breast cancer patients with non-palpable lymph nodes. The present study evaluated the status of sentinel and non-sentinel lymph nodes in T1T2 patients with palpable axillary lymph nodes.
One hundred and two women with early breast cancer were investigated in this study. Patients were selected for axillary sentinel lymph node biopsy and then surgery .Then the rates of false negative and true positive, and diagnostic accuracy of sentinel lymph nodes biopsy were evaluated. In addition, the hormone receptors status of the tumor was determined through IHC and data was analyzed in SPSS21.
In this study, the mean age of the patients was 49 years, 85% had invasive ductal carcinoma in their pathology reports, 77% were ER/PR positive, 30% HER2 positive and 9.8% triple negative and 69% had KI67<14%. In frozen pathology, 15.7 and 84.3% were sentinel positive and negative, respectively, and in the final pathology, 41 and 58.8% were sentinel positive and negative, respectively. This difference arises from the false negative rate of the frozen pathology, which was about 31.3%. The sensitivity, specificity, and diagnostic accuracy of the frozen section were 24, 90 and 43%, respectively. Lymphovascular invasion is an important effective factor in the involvement of sentinel and non-sentinel lymph nodes. Statistical analysis showed that the probability of sentinel and non-sentinel lymph nodes involvement was higher in receptor positive patients and those with KI67>14% (p<0.002) whereas the rate of involvement was lower in triple negative patients.
Sentinel node biopsy can be used in a significant percentage of breast cancer patients with palpable and reactive axillary lymph nodes.
前哨淋巴结活检术是一种可靠的方法，可用于评估触诊阴性腋窝淋巴结的早期乳腺癌患者的腋窝淋巴结状态。本研究评估了触诊阳性腋窝淋巴结的 T1T2 患者前哨和非前哨淋巴结的状态。
本研究共纳入 102 例早期乳腺癌患者。患者选择行腋窝前哨淋巴结活检术，然后行手术治疗。然后评估前哨淋巴结活检术的假阴性和真阳性率以及诊断准确性。此外，通过免疫组化（IHC）确定肿瘤的激素受体状态，并在 SPSS21 中进行数据分析。
在这项研究中，患者的平均年龄为 49 岁，85%的患者病理报告为浸润性导管癌，77%的患者雌激素受体（ER）/孕激素受体（PR）阳性，30%的患者人表皮生长因子受体 2（HER2）阳性，9.8%的患者三阴性，69%的患者 Ki67<14%。在冷冻病理中，前哨淋巴结阳性和阴性的比例分别为 15.7%和 84.3%，而在最终病理中，前哨淋巴结阳性和阴性的比例分别为 41%和 58.8%。这种差异源于冷冻病理的假阴性率，约为 31.3%。冷冻切片的灵敏度、特异性和诊断准确性分别为 24%、90%和 43%。淋巴管侵犯是前哨和非前哨淋巴结受累的重要有效因素。统计分析显示，受体阳性患者和 Ki67>14%的患者前哨和非前哨淋巴结受累的概率更高（p<0.002），而三阴性患者的受累率较低。
前哨淋巴结活检术可用于触诊阳性和反应性腋窝淋巴结的乳腺癌患者的较大比例。
