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被遗忘的节点:腋窝手术需要专业技能。

The forgotten node: Axillary surgery mandates expertise.

机构信息

Breast Radiation Therapy Unit, Sheba Tel Hashomer, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

Breast Center, University Hospital Basel, University of Basel, Basel, Switzerland.

出版信息

Eur J Surg Oncol. 2022 Sep;48(9):1922-1924. doi: 10.1016/j.ejso.2022.05.012. Epub 2022 May 17.

DOI:10.1016/j.ejso.2022.05.012
PMID:35654700
Abstract

The therapeutic role of axillary dissection in breast cancer is gradually abandoned. However, in some cases axillary dissection is still indicated, and this mandates expertise in planning the operation according to imaging, understanding of current methods of axillary marking, and expertise in performing a more radical resection. In this comment we describe cases of gross nodal disease that was left behind at the time of axillary dissection and was later noted on a radiation planning CT.

摘要

腋窝清扫术在乳腺癌治疗中的作用正逐渐被摒弃。然而,在某些情况下仍需要进行腋窝清扫术,这需要根据影像学进行手术规划的专业知识、了解当前腋窝标记方法,并具备进行更彻底切除的专业技能。在本评论中,我们描述了在腋窝清扫术时遗留的大体淋巴结疾病,这些疾病后来在放射治疗计划 CT 上被发现。

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The forgotten node: Axillary surgery mandates expertise.被遗忘的节点:腋窝手术需要专业技能。
Eur J Surg Oncol. 2022 Sep;48(9):1922-1924. doi: 10.1016/j.ejso.2022.05.012. Epub 2022 May 17.
2
[Optimal treatment of the axilla after positive sentinel lymph node biopsy in early invasive breast cancer. Early results of the OTOASOR trial].[早期浸润性乳腺癌前哨淋巴结活检阳性后腋窝的最佳治疗。OTOASOR试验的早期结果]
Orv Hetil. 2013 Dec 8;154(49):1934-42. doi: 10.1556/OH.2013.29765.
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Breast cancer patients with extra-axillary sentinel nodes only may be spared axillary lymph node dissection.仅具有腋外前哨淋巴结的乳腺癌患者可能无需进行腋窝淋巴结清扫术。
Ann Surg Oncol. 2008 Nov;15(11):3239-43. doi: 10.1245/s10434-008-0120-y. Epub 2008 Sep 5.
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Sentinel node biopsy versus low axillary sampling in women with clinically node negative operable breast cancer.临床腋窝淋巴结阴性的可手术乳腺癌女性患者前哨淋巴结活检与低位腋窝取样的比较
Breast. 2013 Dec;22(6):1081-6. doi: 10.1016/j.breast.2013.06.006. Epub 2013 Aug 13.
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Targeted axillary dissection and sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy - a retrospective study.新辅助化疗后乳腺癌患者的靶向腋窝清扫和前哨淋巴结活检——一项回顾性研究
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[SENTINEL LYMPH NODE BIOPSY AND AXILLARY DISSECTION].[前哨淋巴结活检与腋窝清扫术]
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The role of axillary reverse mapping in intraoperative nodal palpation during sentinel lymph node biopsy.腋窝反显图在术中前哨淋巴结活检时的腋窝淋巴结触诊中的作用。
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Video-assisted breast surgery can sample the second and third sentinel nodes to omit axillary node dissection for sentinel-node-positive patients.电视辅助乳腺手术可以对第二和第三前哨淋巴结进行取样,从而对前哨淋巴结阳性的患者省略腋窝淋巴结清扫术。
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Preoperative Axillary US in Early-Stage Breast Cancer: Potential to Prevent Unnecessary Axillary Lymph Node Dissection.早期乳腺癌的术前腋窝超声:有潜力预防不必要的腋窝淋巴结清扫。
Radiology. 2018 Jul;288(1):55-63. doi: 10.1148/radiol.2018171987. Epub 2018 Mar 20.

引用本文的文献

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Artificial intelligence in breast cancer radiotherapy: Insights from the Toolbox Consortium Delphi study.乳腺癌放疗中的人工智能:来自Toolbox联盟德尔菲研究的见解。
Breast. 2025 Jul 15;83:104537. doi: 10.1016/j.breast.2025.104537.
2
Radiation therapy volumes after primary systemic therapy in breast cancer patients: an international EUBREAST survey.乳腺癌患者接受初次全身治疗后的放射治疗体积:一项国际EUBREAST调查
Radiat Oncol J. 2024 Dec;42(4):308-318. doi: 10.3857/roj.2024.00248. Epub 2024 Dec 16.
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The Lucerne Toolbox 2 to optimise axillary management for early breast cancer: a multidisciplinary expert consensus.
用于优化早期乳腺癌腋窝管理的卢塞恩工具箱2:多学科专家共识
EClinicalMedicine. 2023 Jul 14;61:102085. doi: 10.1016/j.eclinm.2023.102085. eCollection 2023 Jul.
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Axillary surgery in the case of limited involved axillary lymph nodes.腋窝淋巴结受累局限时的腋窝手术。
Gland Surg. 2023 Jun 30;12(6):727-729. doi: 10.21037/gs-23-109. Epub 2023 May 25.
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Uncertainties and controversies in axillary management of patients with breast cancer.腋窝管理中存在的不确定性和争议。
Cancer Treat Rev. 2023 Jun;117:102556. doi: 10.1016/j.ctrv.2023.102556. Epub 2023 Apr 23.