Department of General Surgery, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
Department of Pathology, Goztepe Education and Research Hospital, Istanbul Medeniyet University, Istanbul, Turkey.
J Cancer Res Ther. 2020 Oct-Dec;16(6):1265-1268. doi: 10.4103/jcrt.JCRT_1122_19.
Sentinel lymph node biopsy (SLNB) is accepted as the standard procedure to determine the axillary lymph node metastasis in breast cancer at early stage. However, in many cases with sentinel lymph node positivity, the axilla does not contain any tumor cells. As a result, the accuracy of SLNB to predict axillary lymph node metastasis must be evaluated.
Thousand hundred and fourteen women operated for breast cancer were retrospectively examined. Breast cancer patients without axillary metastasis on clinical examination who had undergone SLNB were included in the study. Sentinel lymph node positivity and axillary lymph node positivity were compared.
Among 1114 women operated for breast cancer, 230 were clinically node negative preoperatively and undergone SLNB. Eighty-three (36%) of the patients were SLNB positive and undergone axillary dissection. Forty-three (51.8%) of them had tumor positive axillary lymph nodes and 40 (48.2%) of them had tumor negative axillary lymph nodes.
In 48.2% of the patients, positive sentinel lymph node does not demonstrate a positive axilla. This finding supports sparing axillary dissection in patients with favorable prognostic factors even if the sentinel lymph node is found to be positive.
Axillary lymph node dissection(ALND) may be spared even if there are macrometastatic sentinel lymph nodes in patients with favorable tumor types who will undergo breast-conserving surgery.
前哨淋巴结活检（SLNB）被认为是确定早期乳腺癌腋窝淋巴结转移的标准程序。然而，在许多前哨淋巴结阳性的情况下，腋窝并不含有任何肿瘤细胞。因此，必须评估 SLNB 预测腋窝淋巴结转移的准确性。
回顾性检查了 1114 名接受乳腺癌手术的女性。纳入研究的患者为术前临床检查无腋窝转移且接受 SLNB 的乳腺癌患者。比较了前哨淋巴结阳性和腋窝淋巴结阳性。
在 1114 名接受乳腺癌手术的女性中，230 名术前临床淋巴结阴性且接受了 SLNB。83 名（36%）患者的 SLNB 阳性并进行了腋窝清扫术。其中 43 名（51.8%）腋窝淋巴结有肿瘤阳性，40 名（48.2%）腋窝淋巴结无肿瘤阳性。
在 48.2%的患者中，阳性前哨淋巴结并未显示出阳性腋窝。这一发现支持在即使前哨淋巴结阳性的情况下，对于具有良好预后因素的患者，也可以避免腋窝淋巴结清扫术。
即使在具有良好肿瘤类型且将接受保乳手术的患者中，如果存在大转移的前哨淋巴结，也可以避免腋窝淋巴结清扫术（ALND）。
