Department of Surgical Oncology, Nicolaus Copernicus University Ludwik Rydygier's Collegium Medicum, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.
Department of Clinical Breast Cancer and Reconstructive Surgery, Oncology Centre, Prof I. Romanowskiej 2, 85-796, Bydgoszcz, Poland.
Sci Rep. 2021 Apr 26;11(1):8982. doi: 10.1038/s41598-021-88351-z.
In some breast cancer (BC) patients, an examination of lymph nodes dissected during sentinel lymph node biopsy (SLNB) demonstrates a presence of metastatic lesions and extracapsular extension (ECE) in a SLN. This study aimed to evaluate clinical relevance of ECE in BC patients. This is a retrospective analysis of 891 patients with cancer metastases to SLN, referred to supplementary axillary lymph node dissection (ALND), hospitalized between Jan 2007 and Dec 2017. Clinical and epidemiological data was evaluated. Long-term treatment outcomes were analysed. In 433 (48.6%) patients, cancer metastases were limited to the SLN (group I), in 61 (6.8%) patients the SLN capsule was exceeded focally (≤ 1 mm-group II). In 397 (44.6%) patients, a more extensive ECE was found (> 1 mm-group III). Metastases to non-sentinel lymph nodes (nSLNs) were diagnosed in 27.0% patients from group I, 44.3% patients from group II and in 49.6% patients from group III. No statistically significant differences were observed in long-term treatment outcomes for compared groups. The presence of ECE is accompanied by a higher stage of metastatic lesions in the lymphatic system. The differences in this respect were statistically significant, when compared to the group of ECE(-) patients. ECE, regardless of its extent, did not impact the long-term treatment results. ECE remains an indication for supplementary ALND and for other equivalent cancer treatment procedures, regardless of ECE size.
在一些乳腺癌（BC）患者中，对在 SLNB 期间进行的淋巴结清扫的检查显示 SLN 中存在转移性病变和包膜外扩展（ECE）。本研究旨在评估 ECE 在 BC 患者中的临床相关性。这是对 2007 年 1 月至 2017 年 12 月间接受补充腋窝淋巴结清扫术（ALND）的 891 例癌症转移至 SLN 的患者的回顾性分析。评估了临床和流行病学数据。分析了长期治疗结果。在 433 例（48.6%）患者中，癌症转移仅限于 SLN（I 组），在 61 例（6.8%）患者中，SLN 包膜局部侵犯（≤1mm- II 组）。在 397 例（44.6%）患者中，发现更广泛的 ECE（>1mm-III 组）。I 组患者中有 27.0%、II 组患者中有 44.3%、III 组患者中有 49.6%诊断出非前哨淋巴结（nSLN）转移。各组间的长期治疗结果无统计学差异。ECE 的存在伴随着淋巴结系统中转移性病变的更高分期。与 ECE（-）患者相比，这方面的差异具有统计学意义。无论 ECE 程度如何，都不会影响长期治疗结果。ECE 仍然是进行补充 ALND 和其他等效癌症治疗程序的指征，无论 ECE 大小如何。
