评估Magseed®在乳腺癌患者新辅助全身治疗前后腋窝淋巴结标记:磁体研究。

IF 1.9 4区 医学 Q3 OBSTETRICS & GYNECOLOGY
María Martínez, Sara Jiménez, Florentina Guzmán, Marta Fernández, Elena Arizaga, Consuelo Sanz
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引用次数: 0

摘要

背景:由于新辅助全身治疗(NAST)后与前哨淋巴结活检(SLNB)相关的高假阴性率(FNR),对于最初腋窝阳性并适应NAST的患者,标准的手术治疗是腋窝淋巴结清扫(ALND)。为了避免不必要的ALND,这项多中心、前瞻性、观察性研究旨在确定磁性种子(Magseed®)在NAST术前或术后用于靶向腋窝解剖(TAD)的有效性和便利性。材料和方法:我们招募了81例诊断为T1-T3乳腺癌,临床/影像学上淋巴结累及阳性的患者(cN1, 75例1-3个淋巴结疑似淋巴结,6例4个淋巴结疑似淋巴结)。细针穿刺活检或芯针活检检测到的阳性淋巴结在手术前(NAST后组)使用Magseed®进行标记,或在NAST前(NAST前组)直接使用Magseed®进行标记。根据各中心的标准方案,采用OSNA法(Sysmex Corporation, Kobe)或常规切片和染色技术进行病理评估,计算Magseed®标记淋巴结(MLNs)与前哨淋巴结(SLNs)的相关性。结果:在Sentimag®磁强计系统的指导下,所有磁性粒子在手术10分钟内被成功识别和回收。mln与sln的总体一致性率为81.5%,mln与有转移的sln的总体一致性率为93.8%。转移在54.3%的mln和48.1%的sln中检测到。在MLN阴性和SLN阴性(TAD阴性)的病例中,FNR为0%。在nast后组和nast前组之间没有发现显著差异。结论:我们的研究结果验证了Magseed®用于腋窝淋巴结的长期标记,并表明当与SLNB联合用于TAD时,FNR可以达到0%,避免了不必要的ALND。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

Evaluation of Axillary Lymph Node Marking with Magseed® before and after Neoadjuvant Systemic Therapy in Breast Cancer Patients: MAGNET Study

Background. Due to the high false negative rate (FNR) associated with sentinel lymph node biopsy (SLNB) after neoadjuvant systemic therapy (NAST), the standard surgical treatment for patients with an initially positive axilla and indicated for NAST is axillary lymph node dissection (ALND). To avoid unnecessary ALND, this multicenter, prospective, observational study aimed to determine the effectiveness and ease of using magnetic seeds (Magseed®) for targeted axillary dissection (TAD) when the seeds are placed before or after NAST. Materials and Methods. We recruited 81 patients diagnosed with T1-T3 breast cancer, with clinically/radiologically positive nodal involvement (cN1, 75 patients with 1–3 nodes suspected nodes and 6 patients with up to 4 suspected nodes) prior to NAST. Positive nodes detected by fine-needle aspiration biopsy or core needle biopsy were marked with a stainless steel marker coil and after NAST with Magseed® prior to surgery (Post-NAST group), or directly with Magseed® before NAST (Pre-NAST group). The correlation between lymph nodes marked with Magseed® (MLNs) and sentinel lymph nodes (SLNs) was calculated based on pathologic assessment with the OSNA assay (Sysmex Corporation, Kobe) or conventional sectioning and staining techniques according to the standard protocols of each center. Results. All magnetic seeds were successfully identified and retrieved in just over 10 minutes of surgery, guided by the Sentimag® magnetometer system. The overall concordance rate between MLNs and SLNs was 81.5%, and the concordance between MLNs and SLNs with metastasis was 93.8%. Metastasis was detected in 54.3% of the MLNs compared with 48.1% of SLNs. In cases that presented negative MLN and negative SLN (negative TAD), the FNR was 0%. No significant differences were found between the Post-NAST and Pre-NAST groups. Conclusions. Our results validate the use of Magseed® for long-term marking of axillary lymph nodes and show that when used in combination with SLNB for TAD, a FNR of 0% can be achieved, avoiding unnecessary ALND.

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来源期刊
Breast Journal
Breast Journal 医学-妇产科学
CiteScore
4.00
自引率
0.00%
发文量
47
审稿时长
4-8 weeks
期刊介绍: The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include: Risk Factors Prevention Early Detection Diagnosis and Therapy Psychological Issues Quality of Life Biology of Breast Cancer.
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