前哨淋巴结有一至三个阳性微转移或大转移的乳腺癌患者的腋窝手术:一项观察性研究。

IF 2.9
Breast cancer (Tokyo, Japan) Pub Date : 2025-09-01 Epub Date: 2025-05-25 DOI:10.1007/s12282-025-01726-2
Shigeru Imoto, Hiroyuki Yasojima, Takeshi Nagashima, Tatsuya Onishi, Tsutomu Takashima, Masahiro Kitada, Masaya Kawada, Tetsu Hayashida, Yasuto Naoi, Tomohiko Aihara, Noriaki Wada, Hidetaka Kawabata, Masayuki Yoshida, Uhi Toh, Kimiyasu Yoneyama, Akimitsu Yamada, Hitoshi Tsuda, Norikazu Masuda, Mari Saito-Oba, Junichi Sakamoto
{"title":"前哨淋巴结有一至三个阳性微转移或大转移的乳腺癌患者的腋窝手术:一项观察性研究。","authors":"Shigeru Imoto, Hiroyuki Yasojima, Takeshi Nagashima, Tatsuya Onishi, Tsutomu Takashima, Masahiro Kitada, Masaya Kawada, Tetsu Hayashida, Yasuto Naoi, Tomohiko Aihara, Noriaki Wada, Hidetaka Kawabata, Masayuki Yoshida, Uhi Toh, Kimiyasu Yoneyama, Akimitsu Yamada, Hitoshi Tsuda, Norikazu Masuda, Mari Saito-Oba, Junichi Sakamoto","doi":"10.1007/s12282-025-01726-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN).</p><p><strong>Patients and methods: </strong>Female patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups.</p><p><strong>Results: </strong>Of the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively.</p><p><strong>Conclusions: </strong>ALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1013-1022"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394296/pdf/","citationCount":"0","resultStr":"{\"title\":\"Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.\",\"authors\":\"Shigeru Imoto, Hiroyuki Yasojima, Takeshi Nagashima, Tatsuya Onishi, Tsutomu Takashima, Masahiro Kitada, Masaya Kawada, Tetsu Hayashida, Yasuto Naoi, Tomohiko Aihara, Noriaki Wada, Hidetaka Kawabata, Masayuki Yoshida, Uhi Toh, Kimiyasu Yoneyama, Akimitsu Yamada, Hitoshi Tsuda, Norikazu Masuda, Mari Saito-Oba, Junichi Sakamoto\",\"doi\":\"10.1007/s12282-025-01726-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN).</p><p><strong>Patients and methods: </strong>Female patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups.</p><p><strong>Results: </strong>Of the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively.</p><p><strong>Conclusions: </strong>ALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.</p>\",\"PeriodicalId\":520574,\"journal\":{\"name\":\"Breast cancer (Tokyo, Japan)\",\"volume\":\" \",\"pages\":\"1013-1022\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12394296/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast cancer (Tokyo, Japan)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1007/s12282-025-01726-2\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast cancer (Tokyo, Japan)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1007/s12282-025-01726-2","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/25 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:日本前哨淋巴结导航外科学会进行了一项多机构前瞻性队列研究,比较前哨淋巴结活检(SNB)和SNB后腋窝淋巴结清扫(ALND)对前哨淋巴结(SLN)阳性乳腺癌患者的影响。患者和方法:纳入cT1-3N0-1M0的女性乳腺癌患者。在组织学或分子诊断证实的SLN中有1 - 3个阳性微转移或大转移的病例中,在医生的判断下进行SNB (SNB组)或额外的ALND (ALND组)。主要终点是SNB组5年区域淋巴结(RN)复发率。采用倾向评分匹配(PSM)比较两组患者的预后。结果:在2013年至2016年登记的871例符合条件的病例中,308例仅接受了SNB治疗。中位随访6.3年,5年RN复发率为2.7%。经PSM后,每组配对209例。保乳手术225例(54%),乳房切除术193例(46%)。1例SLN阳性366例(88%),2例48例(11%),3例4例(1%)。SLN的宏观转移和微转移分别为271例(65%)和147例(35%)。SNB组和ALND组分别有42例(20%)和13例(6%)进行了区域淋巴结照射(RNI)。5年RN复发率分别为2.1%和2.0%。结论:无论乳房手术类型如何,单侧SLN阳性的早期乳腺癌患者不需要ALND。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.

Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.

Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.

Axillary surgery in patients with breast cancer with one to three positive micro- or macrometastases in the sentinel lymph nodes: an observational study.

Background: The Japanese Society for Sentinel Node Navigation Surgery conducted a multi-institutional prospective cohort study to compare sentinel node biopsy (SNB) with SNB followed by axillary lymph node dissection (ALND) in breast cancer patients with positive sentinel lymph node (SLN).

Patients and methods: Female patients with breast cancer with cT1-3N0-1M0 were eligible. In cases of one to three positive micro- or macrometastases in the SLN confirmed by histological or molecular diagnosis, SNB alone (SNB group) or additional ALND (ALND group) was performed under physician's discretion. The primary endpoint was the 5-year regional node (RN) recurrence rate in the SNB group. Propensity score matching (PSM) was performed to compare the prognosis between the two groups.

Results: Of the 871 eligible cases registered between 2013 and 2016, 308 underwent SNB alone. At the median follow-up of 6.3 years, 5-year RN recurrence rate was 2.7%. After PSM, 209 cases were matched in each group. Breast-conserving surgery and mastectomy were performed in 225 (54%) and 193 cases (46%), respectively. One-positive SLN was recorded in 366 cases (88%), two in 48 (11%), and three in 4 (1%). Macro- and micrometastases in SLN were diagnosed in 271 (65%) and 147 cases (35%), respectively. Regional nodal irradiation (RNI) was performed in 42 (20%) and 13 (6%) cases of the SNB and ALND group. The 5-year RN recurrence rate was 2.1% and 2.0%, respectively.

Conclusions: ALND is not necessary for early breast cancer patients with one-positive SLN despite type of breast surgery.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信