Sentinel lymph node mapping following neoadjuvant chemotherapy for breast cancer.
Sentinel lymph node mapping following neoadjuvant chemotherapy for breast cancer.
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DOI：
10.1046/j.1524-4741.2002.08205.x
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发表时间：
2002-03-01
期刊：
影响因子：
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通讯作者：
Brady, Elizabeth W
中科院分区：
文献类型：
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作者：
Brady, Elizabeth W
本研究的目的是评估在接受乳房肿瘤切除术或乳房切除术之前接受乳腺癌新辅助化疗的患者进行前哨淋巴结标测以及随后进行完整腋窝清扫的前哨淋巴结标测的可行性。回顾性分析了 1998 年 2 月至 2000 年 7 月期间经核心活检诊断为 I 期至 IIIB 期乳腺癌的 14 例患者，他们在确定性手术前接受了新辅助化疗（阿霉素/环磷酰胺），包括肿瘤切除术或乳房切除术和前哨淋巴结标测，然后进行全腋窝清扫。 14 名患者中的 13 名成功识别了前哨淋巴结（93%），所有 14 名患者均接受了全腋窝淋巴结清扫术。每名患者平均发现前哨淋巴结 2.2 个，中位腋窝淋巴结（包括前哨淋巴结）16 个。在 13 名发现前哨淋巴结的患者中，10 名转移阳性（77%）。 10 例中只有 4 例出现进一步腋窝转移（40%）。三名患者的苏木精、伊红和细胞角蛋白染色显示前哨淋巴结呈阴性，并且没有腋窝转移（0% 假阴性）。一名无法识别前哨淋巴结的患者患有 IIIA 期疾病，并伴有广泛的淋巴肿瘤栓塞。前哨淋巴结标测在新辅助化疗乳腺癌患者中是可行的，并且可以使大量患者免于全腋窝清扫的发病率。有必要进一步研究评估该患者群体的前哨淋巴结定位。
The purpose of this study was to evaluate the feasibility of sentinel lymph node mapping in patients undergoing neoadjuvant chemotherapy for breast carcinoma prior to lumpectomy or mastectomy and sentinel lymph node mapping followed by complete axillary dissection. A retrospective analysis of 14 patients from February 1998 to July 2000 with stage I to stage IIIB breast cancer diagnosed by core biopsy underwent neoadjuvant chemotherapy (doxorubicin/cyclophosphamide) prior to definitive surgery, including lumpectomy or mastectomy and sentinel lymph node mapping, followed by full axillary dissection. Thirteen of 14 patients had successful sentinel lymph node identification (93%), and all 14 underwent full axillary dissection. An average of 2.2 sentinel nodes and a median of 16 axillary lymph nodes (including sentinel nodes) were found per patient. Of the 13 patients in whom a sentinel lymph node was identified, 10 were positive for metastases (77%). Only 4 of the 10 had further axillary metastases (40%). Three patients had negative sentinel lymph nodes shown by hematoxylin and eosin and cytokeratin stainings and had no axillary metastases (0% false negative). The single patient in whom a sentinel lymph node could not be identified had stage IIIA disease with extensive lymphatic tumor emboli. Sentinel lymph node mapping is feasible in neoadjuvant chemotherapy breast cancer patients and can spare a significant number of patients the morbidity of full axillary dissection. Further study to evaluate sentinel lymph node mapping in this patient population is warranted.