Sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy
Sentinel lymph node biopsy in breast cancer patients after neoadjuvant chemotherapy
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DOI：
10.1002/jso.10294
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发表时间：
2003-10-01
影响因子：
2.5
通讯作者：
Prokop, E
中科院分区：
文献类型：
--
作者：
Reitsamer, R;Peintinger, F;Prokop, E
背景和目的：前哨淋巴结活检（SLNB）是早期乳腺癌患者腋窝分期的一种准确方法。本研究的目的是评估SLNB的准确性和可行性，在乳腺癌患者接受术前（新辅助）chemotherapy.Methods：晚期乳腺癌II期或III期谁是新辅助化疗治疗的患者被纳入本研究。尝试并进行前哨淋巴结（SLN）识别和活检，并在SLNB后的同一外科手术中进行腋窝淋巴结清扫（ALND）。结果：30例患者均行前哨淋巴结和腋窝淋巴结的病理组织学检查，并比较淋巴结的状态。经瘤周注射~（99）Tc标记人血白蛋白和乳晕下皮下注射蓝色染料后，26/30例患者的前哨淋巴结可被识别，识别率为86.7%。在4/30例患者（13.3%）中，无法识别SLN。在25/26例患者（96.2%）中，SLN准确预测了腋窝状况。11例SLN阴性，ALND淋巴结阴性。6例SLN阳性，ALND中淋巴结阳性。8例仅SLN阳性，ALND内淋巴结阴性。1例SLNB为假阴性，假阴性率为6.7%（1/15）。结论：SLNB是一种用于早期乳腺癌腋窝分期的有效方法。新辅助化疗后SLNB的准确性与初次手术患者相似。SLNB可作为新辅助化疗后患者亚组ALND的替代方法，因此可降低这些患者因手术导致的发病率。由于患者数量较少，需要在该患者亚组中进行进一步评价。(C)2003 Wiley-Liss，Inc.
Background and Objectives: Sentinel lymph node biopsy (SLNB) is an accurate method for axillary staging in patients with early breast cancer. The aim of this study was to evaluate the accuracy and the feasibility of SLNB in breast cancer patients who had received preoperative (neoadjuvant) chemotherapy.Methods: Patients with advanced breast cancer stage II or III who were treated with neoadjuvant chemotherapy were included in the study. Sentinel lymph node (SLN) identification and biopsy was attempted and performed, and axillary lymph node dissection (ALND) was performed in the same surgical procedure after SLNB. The histopathologic examination of the SLNs and the dissected axillary lymph nodes was performed and nodal status was compared.Results: Thirty patients were included in the study. After peritumoural injection of technetium-99m labelled human albumin and subareolar subcutaneous injection of blue dye, the SLNs could be identified in 26/30 patients (identification rate 86.7%). In 4/30 patients (13.3%) SLNs could not be identified. In 25/26 patients (96.2%) SLNs accurately predicted the axillary status. Eleven patients had negative SLNs and negative nodes in ALND. Six patients had positive SLNs and positive nodes in ALND. In eight patients SLNs only were positive and nodes in ALND were negative. One patient had a false-negative SLNB, calculating a false-negative rate of 6.7% (1/15).Conclusions: SLNB is a well introduced technique for axillary staging in patients with early breast cancer. The accuracy of SLNB after neoadjuvant chemotherapy is similar to patients with primary surgery. SLNB could be an alternative to ALND in a subgroup of patients after neoadjuvant chemotherapy, and therefore could reduce morbidity due to surgery in those patients. Due to small numbers of patients, further evaluation in this subset of patients is required. (C) 2003 Wiley-Liss, Inc.