Chang Jung Min, Shin Hee Jung, Choi Ji Soo, Shin Sung Ui, Choi Bo Hwa, Kim Min Jung, Yoon Jung Hyun, Chung Jin, Kim Tae Hee, Han Boo-Kyung, Kim Hak Hee, Moon Woo Kyung
Department of Radiology, Seoul National University Hospital, Seoul, Korea.
Department of Radiology and Research Institute of Radiology, Asan Medical Center, Seoul, Korea.
J Breast Cancer. 2021 Dec;24(6):554-560. doi: 10.4048/jbc.2021.24.e47. Epub 2021 Nov 24.
Axillary ultrasonography (US) is the most commonly used imaging modality for nodal evaluation in patients with breast cancer. No Axillary Surgical Treatment in Clinically Lymph Node-Negative Patients after Ultrasonography (NAUTILUS) is a prospective, multicenter, randomized controlled trial investigating whether sentinel lymph node biopsy (SLNB) can be safely omitted in patients with clinically and sonographically node-negative T1-2 breast cancer treated with breast-conserving therapy. In this trial, a standardized imaging protocol and criteria were established for the evaluation of axillary lymph nodes. Women lacking palpable lymph nodes underwent axillary US to dismiss suspicious nodal involvement. Patients with a round hypoechoic node with effaced hilum or indistinct margins were excluded. Patients with T1 tumors and a single node with a cortical thickness ≥ 3 mm underwent US-guided biopsy. Finally, patients with negative axillary US findings were included. The NAUTILUS axillary US nodal assessment criteria facilitate the proper selection of candidates who can omit SLNB. Trial Registration: ClinicalTrials.gov Identifier: NCT04303715.
腋窝超声检查（US）是乳腺癌患者淋巴结评估中最常用的影像学检查方法。超声检查后临床淋巴结阴性患者不进行腋窝手术治疗（NAUTILUS）是一项前瞻性、多中心、随机对照试验，旨在研究对于接受保乳治疗的临床及超声检查淋巴结阴性的T1-2期乳腺癌患者，是否可以安全地省略前哨淋巴结活检（SLNB）。在该试验中，建立了标准化的影像学检查方案和标准用于腋窝淋巴结评估。未触及淋巴结的女性接受腋窝超声检查以排除可疑的淋巴结受累。圆形低回声结节且门部消失或边缘不清的患者被排除。T1期肿瘤且单个淋巴结皮质厚度≥3 mm的患者接受超声引导下活检。最后，纳入腋窝超声检查结果为阴性的患者。NAUTILUS腋窝超声淋巴结评估标准有助于正确选择可以省略SLNB的候选者。试验注册：ClinicalTrials.gov标识符：NCT04303715。
