乳腺癌前哨淋巴结活检中超声异常腋窝淋巴结是否应切除？

IF 2.1 4区医学 Q2 OBSTETRICS & GYNECOLOGY

Breast Care Pub Date : 2025-08-27 DOI:10.1159/000548074

Xing Wang, Zhaoqing Fan, Ling Huo, Tie Fan, Xinguang Wang, Wei Cao, Yingjian He, Tao Ouyang

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引用次数: 0

摘要

背景：在对乳腺癌患者进行前哨淋巴结活检（SNB）时，不确定是否切除了异常淋巴结。异常节点对SNB结果准确性的影响尚不清楚。方法：在这项前瞻性研究中，超声检查异常腋窝淋巴结（saaln）和阴性FNAC结果的乳腺癌患者符合条件。在SNB手术之前，在超声引导下在SAALN处放置定位丝。在SNB手术中，线定位淋巴结（WLNs）和放射性淋巴结被切除并分别标记进行病理检查。结果：WLNs共213例，前哨淋巴结169例（79.3%），非前哨淋巴结44例（20.7%）。病理检查发现79例（37.1%）患者SNs阳性，63例（29.6%）患者WLNs阳性。无论是SNs还是WLNs，均有80例（37.6%）患者出现淋巴结阳性。漏诊率为1.3%（1/80）。SN和WLN阴性患者在中位随访132个月时腋窝复发3次（3/133,2.3%）。结论：乳腺癌患者同时切除FNAC阴性的saaln行SNB可略微降低漏诊率，腋窝局部复发风险低。

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Should Sonographic Abnormal Axillary Lymph Nodes Be Excised in Sentinel Node Biopsy of Breast Cancer?

Background: In sentinel node biopsy (SNB) procedure for breast cancer patient, whether the abnormal node was excised is uncertain. The impact of abnormal node on the accuracy of SNB results is unknown.

Methods: In this prospective study, breast cancer patients with sonographically abnormal axillary lymph nodes (SAALNs) and negative FNAC results were eligible. Before the SNB operation, a localization wire was placed at the SAALN by ultrasound guidance. In the SNB operation, the wire-localized nodes (WLNs) and radioactive nodes were excised and labeled separately for pathological examination.

Results: In total, 213 WLNs, 169 (79.3%) were sentinel nodes (SNs) and 44 (20.7%) were non-SNs. 79 (37.1%) patients had positive SNs and 63 (29.6%) patients had positive WLNs both identified by pathological examination. 80 (37.6%) patients had positive lymph nodes whether it was SNs or WLNs. Omission diagnosis rate of SNB was 1.3% (1/80). Three axillary recurrence events (3/133, 2.3%) occurred in SN and WLN both negative patients at a median follow-up time of 132 months.

Conclusions: Performing SNB by excising the SAALNs with negative FNAC simultaneously in breast cancer patients could reduce the omission diagnosis rate marginally, and the risk of axillary local recurrence is low.

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来源期刊

Breast Care 医学-妇产科学

CiteScore

4.40

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： ''Breast Care'' is a peer-reviewed scientific journal that covers all aspects of breast biology. Due to its interdisciplinary perspective, it encompasses articles on basic research, prevention, diagnosis, and treatment of malignant diseases of the breast. In addition to presenting current developments in clinical research, the scope of clinical practice is broadened by including articles on relevant legal, financial and economic issues.