Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies
Axillary lymph node dissection can be avoided in women with breast cancer with intraoperative, false-negative sentinel lymph node biopsies
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DOI：
10.1007/s12282-009-0154-4
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发表时间：
2010-01-01
期刊：
影响因子：
4
通讯作者：
Tabei, Toshio
中科院分区：
文献类型：
--
作者：
Takei, Hiroyuki;Kurosumi, Masafumi;Tabei, Toshio
背景：目前尚不清楚哪些乳腺癌前哨淋巴结（SLN）转移患者不需要腋窝淋巴结清扫术（ALND）患者和方法一组1,132名患有单侧浸润性乳腺癌的妇女，临床阴性淋巴结或可疑转移的淋巴结，术中诊断为阴性SLN，并没有立即进行ALND。我们的术中组织学研究使用每个SLN的最大切割表面的冷冻切片的H&E染色。在这1，132名女性中，132名（11.7%）术后诊断为阳性SLN，将其归类为术中假阴性SLN活检（SLNB）。对这些患者的患者和肿瘤特征、治疗方法和并发症进行了调查，并与其余1,000例SLNB阴性的患者进行了比较。中位随访期为58.1个月，这些患者均未出现腋窝淋巴结复发。其无复发生存率与SLNB阴性的患者无统计学差异。结论在大多数乳腺癌患者术中，假阴性SLNB可以避免ALND。
Background It is currently unclear which patients with breast cancer with sentinel lymph node (SLN) metastases do not need axillary lymph node dissection (ALND).Patients and methods A cohort of 1,132 women who had unilateral invasive breast cancer with clinically negative nodes or nodes suspicious for metastasis, were intraoperatively diagnosed as having negative SLNs, and did not undergo an immediate ALND. Our intraoperative histological investigation uses H&E staining of a frozen section from a maximum cut surface of each SLN. Of these 1,132 women, 132 (11.7%) were postoperatively diagnosed as having positive SLNs, which classifies them as having an intraoperative, false-negative SLN biopsy (SLNB). Patient and tumor characteristics, treatment methods, and the prognoses of these patients were investigated and compared with the remaining 1,000 patients who were negative for SLNB.Results Of the 132 patients with intraoperative, false-negative SLNB, none underwent a further ALND. With a median follow-up period of 58.1 months, none of these patients exhibited recurrence in the axillary nodes. Their recurrence-free survival rates were not statistically different from those of patients with negative SLNB.Conclusions ALND can be avoided in most patients with breast cancer with intraoperative, false-negative SLNB.