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影响早期乳腺癌非前哨淋巴结转移的因素

Factors Affecting Non-sentinel Lymph Node Metastasis in Early-Stage Breast Cancer.

作者信息

Demircioğlu Zeynep Gül, Demircioğlu Mahmut Kaan, Tanık Canan T, Yetkin Sitki Gurkan

机构信息

General Surgery, Kars Harakani State Hospital, Kars, TUR.

Surgical Oncology, Umraniye Training and Research Hospital, Istanbul, TUR.

出版信息

Cureus. 2024 Nov 22;16(11):e74199. doi: 10.7759/cureus.74199. eCollection 2024 Nov.

Abstract

Objective Breast cancer most commonly metastasizes to axillary lymph nodes via lymphatic drainage. Today, axillary lymph node surgery is at least as important as primary breast surgery. In today's breast surgery, supported by chemotherapy and radiotherapy, current approaches are taken to avoid axillary dissection in appropriate patient groups. In our study, we aimed to evaluate and predict the factors affecting non-sentinel lymph node metastasis in patients with early-stage clinically node-negative breast cancer. Materials and methods Data of 65 female patients were analysed retrospectively. Patient's age, preoperative haemoglobin values, tumour localisation, tumour diameter, number of sentinel lymph nodes sent for frozen examination, and tumour pathological features were investigated in terms of the number of non-sentinel lymph nodes and metastatic lymph nodes removed by axillary dissection, and whether it affects non-sentinel lymph node metastasis was investigated by statistical analysis. Results In the axillary dissection of patients with positive sentinel lymph node metastasis, the number of metastatic non-sentinel lymph nodes was statistically significantly higher in Cerb-B2-positive patients than in Cerb-B2-negative patients (p=0.046). As the stage progressed, the number of metastatic non-sentinel lymph nodes increased as expected (p<0.001). Conclusion In the current axillary surgery, it is a new approach to avoid axillary dissection in appropriate patient groups even if the sentinel lymph node is positive. When planning the surgical treatment of these patients, it should be considered preoperatively that Cerb-B2-positive patients are more prone to axillary non-sentinel lymph node metastasis.

摘要

目的 乳腺癌最常通过淋巴引流转移至腋窝淋巴结。如今,腋窝淋巴结手术至少与原发性乳腺癌手术同样重要。在当今的乳腺癌手术中,在化疗和放疗的支持下,采取了当前的方法来避免在合适的患者群体中进行腋窝清扫术。在我们的研究中,我们旨在评估和预测影响早期临床淋巴结阴性乳腺癌患者非前哨淋巴结转移的因素。

材料与方法 回顾性分析65例女性患者的数据。从腋窝清扫术切除的非前哨淋巴结和转移淋巴结数量方面,研究患者的年龄、术前血红蛋白值、肿瘤定位、肿瘤直径、送去做冰冻检查的前哨淋巴结数量以及肿瘤病理特征,并通过统计分析研究其是否影响非前哨淋巴结转移。

结果 在前哨淋巴结转移阳性的患者腋窝清扫术中,Cerb-B2阳性患者的非前哨转移淋巴结数量在统计学上显著高于Cerb-B2阴性患者(p=0.046)。随着分期进展,非前哨转移淋巴结数量如预期增加(p<0.001)。

结论 在当前的腋窝手术中,即使前哨淋巴结阳性,在合适的患者群体中避免腋窝清扫术是一种新方法。在规划这些患者的手术治疗时,术前应考虑到Cerb-B2阳性患者更易发生腋窝非前哨淋巴结转移。

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Breast Cancer: Current Perspectives on the Disease Status.乳腺癌:疾病现状的当前观点。
Adv Exp Med Biol. 2019;1152:51-64. doi: 10.1007/978-3-030-20301-6_4.

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