Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer
Lymphatic mapping and sentinel lymphadenectomy after preoperative therapy for stage II and III breast cancer
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DOI：
10.1245/aso.2003.05.012
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发表时间：
2003-07-01
影响因子：
3.7
通讯作者：
Kelley, MC
中科院分区：
文献类型：
--
作者：
Balch, GC;Mithani, SK;Kelley, MC
背景资料：我们评估了前哨淋巴结清扫术（SLND）的准确性，在第II和III期乳腺癌患者接受了术前therapeutic.Methods：前瞻性临床试验评估了122例SLND腋窝淋巴结清扫术。32名妇女有II期或III期乳腺癌，并接受术前阿霉素为基础的化疗或紫杉醇和放疗。结果：一个前哨淋巴结（SLN）确定在31（97%）的32例。SLN预测了31例患者中30例（97%）腋窝淋巴结的状态。31例中有18例（58%）在SLN中发生转移。19例腋窝转移患者中有18例SLN阳性（敏感性95%，假阴性率5%）。19名前哨淋巴结转移的女性中，有8名（44%）也在I个或多个非前哨淋巴结转移。结论：在这项相对较小的研究中，接受术前治疗的II期或III期乳腺癌女性的前哨淋巴结转移准确性与早期乳腺癌相似。如果这些结果在更大的队列中得到证实，在这一人群中用SLND代替常规腋窝淋巴结清扫可能是可行的。这种方法可以降低手术治疗的发病率，同时保持腋窝分期的准确性，并保持对这一高危人群的区域控制。
Background: We evaluated the accuracy of sentinel lymph node dissection (SLND) in patients with stage II and III breast cancer who had received preoperative therapy.Methods: A prospective clinical trial evaluated 122 patients who had SLND followed by axillary lymph node dissection. Thirty-two women had stage II or III breast cancer and received preoperative doxorubicin-based chemotherapy or paclitaxel and radiotherapy.Results: A sentinel lymph node (SLN) was identified in 31 (97%) of 32 patients. The SLN predicted the status of the axillary nodes in 30 (97%) of 31 patients. Eighteen (58%) of 31 had metastases in the SLN. Eighteen of 19 patients with axillary metastases had a tumor-positive SLN (sensitivity, 95%; false-negative rate, 5%). Eight (44%) of 19 women with metastases in the SLN also had metastases in I or more nonsentinel nodes.Conclusions: In this relatively small study, the accuracy of SLND in women with stage II or III breast cancer treated with preoperative therapy was similar to that achieved in early-stage breast cancer. If these results are confirmed in a larger cohort, it may be feasible to substitute SLND for routine axillary lymph node dissection in this population. This approach could reduce the morbidity of surgical therapy while preserving the accuracy of axillary staging and maintaining regional control in this high-risk population.