Aitchison Lucy P, Spillane Andrew J
Breast and Melanoma Surgery Department, Royal North Shore Hospital, Reserve Rd, St Leonards, New South Wales, Australia.
MIA Translational Hub, The University of Sydney, Wollstonecraft, New South Wales, Australia.
ANZ J Surg. 2025 Jan-Feb;95(1-2):41-46. doi: 10.1111/ans.19389. Epub 2025 Jan 31.
Breast conservation surgery and sentinel lymph node biopsy via a single incision allows excision of tumours from all quadrants of the breast, with access to both axillary and internal mammary nodal basins with no additional incisions.
This systematic review aims to consolidate the current literature on the efficacy, safety, functional and cosmetic outcomes of single-incision breast conserving surgery and sentinel lymph node biopsy.
A comprehensive search of Pubmed, EMBASE, Medline and GoogleScholar was conducted from inception to 7th July 2024 for all peer-reviewed articles assessing breast conserving surgery and sentinel lymph node biopsy via single incision using PRISMA guidelines.
The literature search generated 426 articles. 400 were excluded by abstract review with the remaining 26 articles reviewed in full. An additional three articles were retrieved from review of full article reference lists. 13 articles were excluded, leaving 10 articles meeting the inclusion criteria. The technique demonstrated success across all quadrants of the breast. Eight studies documented successful axillary dissection completed via a single incision. Four studies compared the single-incision approach to the conventional two-incision technique. There was no difference in complication rates. The single-incision technique was associated with higher patient satisfaction and reduced post-operative axillary pain.
Single-incision breast conservation surgery and sentinel lymph node biopsy is surgically safe and can be feasible for tumours in all quadrants of the breast and is associated with improvement in cosmesis, pain and patient satisfaction. Further studies are required to confirm its long-term oncological safety.
通过单一切口进行保乳手术和前哨淋巴结活检，能够切除乳腺所有象限的肿瘤，可进入腋窝和内乳淋巴结区域，无需额外切口。
本系统评价旨在整合当前关于单一切口保乳手术和前哨淋巴结活检的疗效、安全性、功能及美容效果的文献。
按照PRISMA指南，对PubMed、EMBASE、Medline和Google Scholar进行全面检索，检索时间从数据库建立至2024年7月7日，纳入所有评估单一切口保乳手术和前哨淋巴结活检的同行评议文章。
文献检索共获得426篇文章。通过摘要筛选排除400篇，其余26篇进行全文审查。通过全文参考文献列表回顾又检索到3篇文章。排除13篇，最终10篇文章符合纳入标准。该技术在乳腺所有象限均显示成功。八项研究记录了通过单一切口成功完成腋窝清扫。四项研究将单一切口方法与传统双切口技术进行了比较。并发症发生率无差异。单一切口技术与更高的患者满意度和术后腋窝疼痛减轻相关。
单一切口保乳手术和前哨淋巴结活检手术安全，对乳腺所有象限的肿瘤均可行，且与美容效果改善、疼痛减轻及患者满意度提高相关。需要进一步研究以证实其长期肿瘤学安全性。
