Saksena Mansi, Jimenez Rachel, Coopey Suzanne, Harris Katherine
Massachusetts General Hospital, Department of Imaging, Boston, MA, USA.
Massachusetts General Hospital, Department of Radiation Oncology, Boston, MA, USA.
J Breast Imaging. 2021 Nov 16;3(6):672-675. doi: 10.1093/jbi/wbab070.
Over the past decade, there has been a trend toward de-escalation of axillary surgery. Certain patients may now forego axillary lymph node dissection even in the setting of a positive sentinel lymph node biopsy (SLNB), and some patients may not even undergo a SLNB. However, there is wide variability in the imaging approach to assessing axillary lymph nodes in patients with breast cancer. Approaches range from performing axillary US in all patients with newly diagnosed breast cancer to omitting axillary imaging evaluation in all patients. This article provides a multidisciplinary middle ground approach for axillary nodal evaluation. The clinical impact and rationale for appropriate axillary nodal imaging are discussed and an imaging algorithm is proposed.
在过去十年中，腋窝手术有逐渐减少的趋势。现在，某些患者即使前哨淋巴结活检（SLNB）结果为阳性，也可能放弃腋窝淋巴结清扫，甚至有些患者可能根本不进行SLNB。然而，在评估乳腺癌患者腋窝淋巴结的影像学方法上存在很大差异。方法范围从对所有新诊断的乳腺癌患者进行腋窝超声检查到对所有患者省略腋窝影像学评估。本文提供了一种多学科的腋窝淋巴结评估中间立场方法。讨论了适当的腋窝淋巴结成像的临床影响和基本原理，并提出了一种成像算法。
