Setor de Mastologia da Disciplina de Ginecologia do Departamento de Obstetricia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 251; 4o andar Secretária Cirúrgica, São Paulo, SP 01246-000, Brazil.
Setor de Mastologia da Disciplina de Ginecologia do Departamento de Obstetricia e Ginecologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo (FMUSP), Av. Dr. Arnaldo, 251; 4o andar Secretária Cirúrgica, São Paulo, SP 01246-000, Brazil.
Clinics (Sao Paulo). 2023 May 16;78:100216. doi: 10.1016/j.clinsp.2023.100216. eCollection 2023.
The presence of Extracapsular Extension (ECE) in the Sentinel Lymph Node Biopsy (SLNB) is still a doubt in the literature. Some studies suggest that the presence of ECE may be related to a greater number of positive axillary lymph nodes which could impact Disease Free Survival (DFS) and Overall Survival (OS). This study searches for the clinical significance of the ECE.
Retrospective cohort comparing the presence or absence of ECE in T1-2 invasive breast cancer with positive SLNB. All cases treated surgically at the Cancer Institute of the State of São Paulo (ICESP) between 2009 and 2013 were analyzed. All patients with axillary disease in SLNB underwent AD.
Identify the association between the presence and length of ECE and additional axillary positive lymph nodes, OS and DFS between both groups.
128 patients with positive SLNB were included, and 65 had ECE. The mean metastasis size of 0.62 (SD = 0.59) mm at SLNB was related to the presence of ECE (p < 0.008). The presence of ECE was related to a higher mean of positive sentinel lymph nodes, 3.9 (± 4.8) vs. 2.0 (± 2.1), p = 0.001. The median length of follow-up was 115 months. The OS and DFS rates had no differences between the groups.
The presence of ECE was associated with additional positive axillary lymph nodes in this study. Therefore, the OS and DFS were similar in both groups after 10 years of follow-up. It is necessary for additional studies to define the importance of AD when SLNB with ECE.
前哨淋巴结活检（SLNB）中存在囊外扩展（ECE）在文献中仍然存在疑问。一些研究表明，ECE 的存在可能与更多的阳性腋窝淋巴结相关，这可能会影响无病生存（DFS）和总生存（OS）。本研究旨在探讨 ECE 的临床意义。
回顾性队列研究比较了 T1-2 浸润性乳腺癌伴阳性 SLNB 中 ECE 的存在与否。分析了 2009 年至 2013 年在圣保罗州癌症研究所（ICESP）接受手术治疗的所有病例。所有 SLNB 中存在腋窝疾病的患者均接受了 AD。
共纳入 128 例阳性 SLNB 患者，其中 65 例存在 ECE。SLNB 时的平均转移灶大小为 0.62（SD=0.59）mm，与 ECE 的存在相关（p<0.008）。ECE 的存在与更高的平均阳性前哨淋巴结相关，3.9（±4.8）vs.2.0（±2.1），p=0.001。中位随访时间为 115 个月。两组之间的 OS 和 DFS 率无差异。
本研究中 ECE 的存在与额外的阳性腋窝淋巴结相关。因此，在 10 年的随访后，两组的 OS 和 DFS 相似。需要进一步研究来确定 ECE 时 AD 的重要性。
