- Universidade Federal do Paraná, Departamento de Tocoginecologia - Curitiba - PR - Brasil.
- Universidade Federal do Paraná, Departamento de Radiologia - Curitiba - PR - Brasil.
Rev Col Bras Cir. 2024 Nov 25;51:e20243697. doi: 10.1590/0100-6991e-20243697-en. eCollection 2024.
The use of axillary marking prior to Neoadjuvant Systemic Therapy (NST) is a controversial matter regarding patients with positive Lymph Nodes (LN). Several methods were tested to make possible the decrease of false negative rate in comparison to sentinel lymph node adding more accuracy to the results. This study aims to evaluate the oncological outcomes in patients who had undergone selective axillary dissection with 4% carbon marking before TSN.
A prospective study was performed with cT1-T4, cN1-N2 breast cancer patients classified as suspected LNs undergoing concomitant 4% carbon marking. After TSN, targeted LNs were identified and resected associated to the sentinel lymph node (SLN) biopsy. The oncological outcomes pointed out were overall survival (OS), causespecific survival (CSS), distant disease-free survival (DDFS), axillary recurrence (AR) and local recurrence (LR).
A total of 168 patients were evaluated for a median period of 49 months. The axillary emptying was reached in 89 (50.6%) cases. Five of 168 patients (2.9%) had axillary recurrence (AR). There was a significant link between axillary emptying and AR (0 vs. 6% p = 0.012). The DDFS was 140/168 (83.3%), OS 158/168 (94%) and CSS 158/163 (96.9%).
The use of carbon marking in selective axillary dissection is a reliable low-cost method with simple execution. Among the oncological outcomes AR may not be considered for post downstaging axillary evaluation analysis since it is a rare event and not necessarily related to OS or DDFS.
在新辅助全身治疗（NST）之前使用腋窝标记对于阳性淋巴结（LN）的患者是一个有争议的问题。已经测试了几种方法来降低与前哨淋巴结相比的假阴性率，从而使结果更准确。本研究旨在评估在接受 TSN 之前进行 4%碳标记的选择性腋窝解剖术的患者的肿瘤学结果。
对 cT1-T4、cN1-N2 乳腺癌患者进行前瞻性研究，这些患者被归类为疑似 LN，并同时进行 4%碳标记。在 TSN 后，识别并切除靶向淋巴结，并与前哨淋巴结（SLN）活检相关。指出的肿瘤学结果包括总生存（OS）、无病特异性生存（CSS）、无远处疾病生存（DDFS）、腋窝复发（AR）和局部复发（LR）。
共有 168 例患者接受了中位时间为 49 个月的评估。89 例（50.6%）达到腋窝排空。168 例患者中有 5 例（2.9%）出现腋窝复发（AR）。腋窝排空与 AR 之间存在显著关联（0%与 6%，p=0.012）。DDFS 为 140/168（83.3%），OS 为 158/168（94%），CSS 为 158/163（96.9%）。
在选择性腋窝解剖术中使用碳标记是一种可靠的、低成本的方法，操作简单。在肿瘤学结果中，AR 可能不被认为是降期后腋窝评估分析的因素，因为它是一种罕见的事件，不一定与 OS 或 DDFS 相关。
