Koller M, Barsuk D, Zippel D, Engelberg S, Ben-Ari G, Papa M Z
Breast Cancer Service, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Eur J Surg Oncol. 1998 Jun;24(3):166-8. doi: 10.1016/s0748-7983(98)92827-x.
Axillary node dissection for breast cancer is important for staging and its prognostic value. Sentinel nodes are defined as the first nodes into which the primary cancer drains. This study investigates whether identification, removal and pathological examination of these nodes indicates whether the completion of axillary lymphadenectomy is required.
Using a vital dye injected at the primary tumour site, we were able to identify sentinel nodes in 96 out of 98 women examined.
An average number of 2.7 +/- 1.2 nodes per patient were identified as sentinel nodes. In 83% of cases there was a correlation between the involvement of the sentinel nodes and the rest of the axillary nodes. In 14% of patients the sentinel nodes were the only nodes involved with tumour. In three cases the sentinel nodes were negative, but other axillary nodes were tumour-positive.
The major problem in routine application of this method to the decision to perform axillary lymph node dissection (ALND) is the time needed for pathological identification of lymph node involvement by tumor.
乳腺癌腋窝淋巴结清扫对于分期及预后评估具有重要意义。前哨淋巴结被定义为原发癌首先引流至的淋巴结。本研究旨在探讨这些淋巴结的识别、切除及病理检查是否能表明是否需要完成腋窝淋巴结清扫术。
通过在原发肿瘤部位注射活性染料，我们在98例接受检查的女性中识别出了96例的前哨淋巴结。
每位患者平均识别出2.7±1.2个前哨淋巴结。在83%的病例中，前哨淋巴结受累与腋窝其他淋巴结受累之间存在相关性。在14%的患者中，前哨淋巴结是唯一受累的淋巴结。有3例患者前哨淋巴结为阴性，但其他腋窝淋巴结为肿瘤阳性。
将该方法常规应用于决定是否进行腋窝淋巴结清扫术（ALND）的主要问题在于病理鉴定肿瘤累及淋巴结所需的时间。
