Matsubara Yuka, Suganuma Nobuyasu, Nakamoto Shogo, Kikawa Yuichiro, Iwamoto Takayuki, Yamanaka Takashi, Yoshida Tatsuya, Yamashita Toshinari, Saitou Aya
Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan.
Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
Breast Cancer. 2025 May;32(3):512-519. doi: 10.1007/s12282-025-01679-6. Epub 2025 Feb 13.
In the realm of surgical therapy for cN0 early breast cancer, sentinel lymph node biopsy (SNB) has been established as a technique that allows the omission of axillary lymph node dissection (Ax) while maintaining local control in the axillary region.
This retrospective study analyzed data from 52 patients who underwent reSNB for IBTR after initial breast-conserving surgery at Kanagawa Cancer Center between June 2012 and March 2019. reSNB was conducted using both the dye and radioactive isotope methods. The identification rate was defined as the number of cases in which sentinel lymph nodes were visualized on lymphoscintigraphy images divided by the total number of cases. The identification rate was compared according to the initial surgical procedure.
Overall, the identification rate for reSNB was 94.2%. The identification rate for reSNB in the axilla was higher in patients who initially underwent SNB than in those who initially underwent axillary lymph node dissection (83.3% vs. 42.9%). ReSNB positivity was observed in three patients (6.7%) in the ipsilateral axilla, whereas no metastasis was detected in the contralateral axilla or internal mammary region. Although four cases of recurrence were observed after reoperation, there was no local recurrence in the ipsilateral axillary region.
reSNB demonstrated high identification rates, comparable to those of initial SNB, with a low rate of positive metastasis and no local recurrence in the ipsilateral axillary region. Despite the limited number of cases, these findings suggest the clinical significance of reSNB in IBTR cases.
在cN0早期乳腺癌的外科治疗领域，前哨淋巴结活检（SNB）已成为一种技术，可在维持腋窝区域局部控制的同时省略腋窝淋巴结清扫术（Ax）。
这项回顾性研究分析了2012年6月至2019年3月在神奈川癌症中心接受初次保乳手术后因同侧乳房肿瘤复发（IBTR）而行再次前哨淋巴结活检（reSNB）的52例患者的数据。reSNB采用染料法和放射性同位素法。识别率定义为在淋巴闪烁显像图像上可见前哨淋巴结的病例数除以病例总数。根据初次手术方式比较识别率。
总体而言，reSNB的识别率为94.2%。最初接受SNB的患者reSNB在腋窝的识别率高于最初接受腋窝淋巴结清扫术的患者（83.3%对42.9%）。在同侧腋窝有3例患者（6.7%）reSNB呈阳性，而在对侧腋窝或内乳区域未检测到转移。尽管再次手术后观察到4例复发，但同侧腋窝区域无局部复发。
reSNB显示出较高的识别率，与初次SNB相当，转移阳性率低，同侧腋窝区域无局部复发。尽管病例数有限，但这些发现提示了reSNB在IBTR病例中的临床意义。
