Morbidity after sentinel lymph node biopsy in primary breast cancer: Results from a randomized controlled trial
Morbidity after sentinel lymph node biopsy in primary breast cancer: Results from a randomized controlled trial
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DOI：
10.1200/jco.2005.03.228
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发表时间：
2005-07-01
影响因子：
45.3
通讯作者：
Duffy, SW
中科院分区：
文献类型：
--
作者：
Purushotham, AD;Upponi, S;Duffy, SW
目的 腋窝淋巴结清扫术（ALND）作为乳腺癌患者手术治疗的一部分与显着的发病率相关。前哨淋巴结活检 (SLNB) 是一种新开发的腋窝分期方法，有可能避免淋巴结阴性患者出现 ALND，从而最大限度地降低发病率。本研究的目的是在一项随机对照试验中调查 SLNB 治疗早期乳腺癌后的身体和心理发病率。 患者和方法 1999 年 11 月至 2003 年 2 月期间，298 名早期乳腺癌患者（肿瘤直径为 3 cm 或以下）临床淋巴结阴性的患者被随机分配接受 ALND（对照组）或 SLNB，如果随后发现淋巴结阳性则接受 ALND（研究组）。术后 1 年期间对身体和心理发病率进行了详细评估。 结果 研究组观察到术后手臂肿胀、血清肿形成率、麻木、对轻触和针刺敏感性丧失的显着减少，尽管研究组平均肩关节活动度受损较小，但这仅在 1 个月时外展和 3 个月时屈曲方面显着。研究组在术后即刻反映生活质量和心理发病率的评分明显更好，长期差异较小。结论 接受乳腺癌手术的患者进行前哨淋巴结活检可显着降低身体和心理发病率。 (c) 2005 年，美国临床肿瘤学会。
Purpose Axillary lymph node dissection (ALND) as part of surgical treatment for patients with breast cancer is associated with significant morbidity. Sentinel lymph node biopsy (SLNB) is a newly developed method of staging the axilla and has the potential to avoid an ALND in lymph node-negative patients, thereby minimizing morbidity, The aim of this study was to investigate physical and psychological morbidity after SLNB in the treatment of early breast cancer in a randomized controlled trial.Patients and Methods Between November 1999 and February 2003, 298 patients with early breast cancer (tumors 3 cm or less on ultrasound examination) who were clinically node negative were randomly allocated to undergo ALND (control group) or SLNB followed by ALND if subsequently found to be lymph node positive (study group). A detailed assessment of physical and psychological morbidity was performed during a 1-year period postoperatively.Results A significant reduction in postoperative arm swelling, rate of seroma formation, numbness, loss of sensitivity to light touch and pinprick was observed in the study group, Although shoulder mobility was less impaired on average in the study group, this was significant only for abduction at 1 month and flexion at 3 months. Scores reflecting quality of life and psychological morbidity were significantly better in the study group in the immediate postoperative period, with fewer long-term differences.Conclusion SLNB in patients undergoing surgery for breast cancer results in a significant reduction in physical and psychological morbidity. (c) 2005 by American Society of Clinical Oncology.