The feasibility of sentinel node biopsy in the previously treated breast
The feasibility of sentinel node biopsy in the previously treated breast
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DOI：
10.1016/j.ejso.2007.04.007
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发表时间：
2008-04-01
期刊：
影响因子：
3.8
通讯作者：
Saga, T.
中科院分区：
文献类型：
--
作者：
Koizumi, M.;Koyama, M.;Saga, T.
目的：前哨淋巴结活检（SNB）已成为早期乳腺癌的标准技术。然而，目前尚不清楚SNB手术是否适用于第二次乳腺癌或先前治疗过的乳腺癌复发。本研究的目的是澄清的可行性SNB程序在乳腺癌发生在以前治疗的乳房，并探讨相关的因素改变lymphatic flow.Patients和方法：2004年4月至2006年12月，1490例患者进行了乳腺SNB程序。其中，31例患者在同一乳房有既往治疗史。近期切除活检病例未纳入该组。所有患者均在同一乳房进行过保乳手术。16例患者进行了腋窝淋巴结清扫，3例进行了SNB，12例未进行腋窝治疗。10例患者接受了乳房和腋窝放射治疗。结果：23例患者腋窝淋巴结、7例内乳淋巴结和7例对侧腋窝淋巴结均显示，其中7例为对侧腋窝淋巴结。既往行腋窝淋巴结清扫术的患者淋巴结分布改变，但未发现对侧腋窝淋巴结受累。10例既往接受过乳腺照射的患者中，7例出现对侧腋窝淋巴结显影，而与腋窝淋巴结清扫无关。28例患者接受了SNB，其中4例显示癌阳性淋巴结。3例非同侧腋窝淋巴结癌细胞阳性（1例对侧腋窝淋巴结癌细胞阳性，2例内乳淋巴结癌细胞阳性）。乳腺照射可能是对侧腋窝淋巴结可视化的一个重要因素。尽管淋巴流的频繁改变，SNB似乎是可行的继发性或复发性乳腺癌患者。(C)2007爱思唯尔有限公司保留所有权利。
Purpose: Sentinel lymph node biopsy (SNB) has been a standard technique in early breast cancer. However, it is not clear that the SNB procedure can be applied to second breast cancer or recurrence occurring in the previously treated breast. The purpose of this study was to clarify the feasibility of the SNB procedure in breast cancer occurring in the previously treated breast, and to investigate the factors related to altered lymphatic flow.Patients and methods: Between April 2004 and December 2006, 1490 patients underwent the breast SNB procedure. Among them, 31 patients had a history of previous treatments in the same breast. Recent excision biopsy cases were not included in this group. All patients had previous breast-conserving surgery in the same breast. Sixteen patients had axillary dissection, 3 had SNB, and 12 had no axillary treatment. Ten patients had received radiation therapy to the breast and axilla. Visualization of axillary nodes, internal mammary nodes and contralateral axillary nodes was evaluated and compared with pathological results.Results: Axillary nodes were visualized in 23 patients, internal mammary nodes in 7 patients, and contralateral axillary nodes in 7 patients. The patients with previous axillary dissection exhibited altered lymph node distribution, but did not show involvement of contralateral axillary nodes. Visualization of contralateral axillary nodes occurred in 7 of the 10 patients with previous irradiation to breast irrespective of axillary dissection. Twenty-eight patients underwent SNB, 4 of whom showed cancer-positive nodes. Three patients were cancer-positive in non-ipsilateral axillary nodes (one patient showed positive opposite axillary node and two patients showed positive internal mammary nodes).Conclusion: Previous axillary dissection or irradiation to the breast greatly influences lymphatic flow. Irradiation to the breast may be a strong factor for the visualization of contralateral axillary nodes. Despite the frequent alteration of lymphatic flow, SNB seems to be feasible in secondary or recurrent breast cancer patients. (C) 2007 Elsevier Ltd. All rights reserved.