School of Medicine, University of Kansas Medical Center, Kansas City, KS, USA.
Department of Radiology, Division of Breast Imaging, University of Kansas Medical Center, Kansas City, KS, USA.
Am J Surg. 2022 Jan;223(1):101-105. doi: 10.1016/j.amjsurg.2021.07.021. Epub 2021 Jul 21.
BACKGROUND: When borderline axillary lymph nodes (bALN) are identified on ultrasound (US) for breast cancer (BC) patients, preoperative management is unclear. We aimed to evaluate if core needle biopsy (CNB) for bALN is clinically helpful or disruptive. METHODS: Retrospective review of BC patients with bALN from 2014 to 2019 was performed. Clinicopathologic data were compared for those who did and did not have CNB. RESULTS: CNB (n = 34) and no CNB (n = 31) were similar with respect to clinicopathologic factors. Surgical LN-positive rate was the same between cohorts (p = 0.26). CNB was disruptive in 58.8 %; all had CNB for pN0 disease. CNB was helpful in 34.2 %: 14.7 % proceeded directly to axillary dissection; 17.6 % had positive LN localized after neoadjuvant chemotherapy. CONCLUSIONS: CNB for bALN is more likely clinically disruptive and did not impact surgical LN positive rate. BC patients with bALN should undergo CNB only if it will change clinical management.
背景：对于乳腺癌患者，如果超声检查发现边界性腋窝淋巴结（bALN），术前管理尚不清楚。我们旨在评估对 bALN 进行核心针活检（CNB）是否具有临床意义。
方法：对 2014 年至 2019 年期间患有 bALN 的乳腺癌患者进行回顾性研究。比较了行 CNB 和不行 CNB 的患者的临床病理数据。
结果：CNB（n=34）和未行 CNB（n=31）两组在临床病理因素方面相似。两组的手术淋巴结阳性率相同（p=0.26）。CNB 具有破坏性，占 58.8%：所有 pN0 疾病患者均进行 CNB；CNB 具有辅助作用，占 34.2%：14.7%的患者直接行腋窝清扫术；17.6%的患者在新辅助化疗后发现局部淋巴结阳性。
结论：对 bALN 进行 CNB 更有可能具有临床破坏性，且不会影响手术淋巴结阳性率。只有当 CNB 会改变临床管理时，才应对 bALN 患者进行 CNB。
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