乳腺癌新辅助治疗前哨淋巴结处理原则  

Principles of sentinel lymph node management in neoadjuvant therapy for breast cancer

作　　者：于理想[1] 余之刚[1] YU Li-xiang;YU Zhi-gang(Department of Breast Surgery,the Second Hospital,Cheeloo College of Medicine,Shandong University,Institute of Translational Medicine of Breast Disease Prevention and Treatment,Shandong University,Engineering Laboratory of Translational Research on Prevention and Treatment of Breast Disease,Shandong Province,Jinan 250033,China)

机构地区：[1]山东大学第二医院乳腺外科山东大学乳腺疾病防治转化医学研究所山东省乳腺疾病防治转化工程实验室,山东济南250033

出　　处：《中国实用外科杂志》2021年第11期1230-1234,共5页Chinese Journal of Practical Surgery

基　　金：山东省医学会科研基金(No.YXH2020ZX064)。

摘　　要：前哨淋巴结活检及新辅助治疗已成为乳腺癌综合治疗的重要措施,也是个体化治疗的重要体现。乳腺癌新辅助治疗具有较高的腋窝淋巴结控制率,如何在乳腺癌新辅助治疗病人中精准、高效实施前哨淋巴结活检引起越来越多的关注。新辅助治疗前后腋窝淋巴结状态的精准评估是实施前哨淋巴结活检的基础。对于新辅助治疗前腋窝淋巴结阴性的病人,推荐新辅助治疗后行前哨淋巴结活检。对于新辅助治疗前腋窝淋巴结阳性,新辅助治疗后淋巴结转阴的病人,需在双示踪、前哨淋巴结检出数≥3枚及阳性淋巴结靶向切除的前提下,进行前哨淋巴结活检,在我国医疗资源现状下,需结合示踪药物的可及性及技术条件,谨慎选择适宜病人。Sentinel lymph node biopsy and neoadjuvant therapy have become important measures for comprehensive treatment of breast cancer,as well as an important embodiment of individual therapy.Neoadjuvant therapy for breast cancer has a high axillary lymph node control rate,and how to accurately and efficiently perform sentinel lymph node biopsy in breast cancer patients undergoing neoadjuvant therapy has attracted more attention.Accurate assessment of axillary lymph node status before and after neoadjuvant therapy is the premise of sentinel lymph node biopsy.For patients with negative axillary lymph nodes before neoadjuvant therapy,sentinel lymph node biopsy after neoadjuvant therapy is recommended.For patients with positive axillary lymph nodes and negative lymph nodes after neoadjuvant therapy,sentinel lymph node biopsy is recommended when dual tracer,removing 3 or more sentinel lymph nodes and targeted axillary dissection technique are used.Under the current situation of medical resources in China,it is necessary to carefully select suitable patients in combination with the accessibility of tracer drugs and technical conditions.

关 键 词：乳腺癌 前哨淋巴结活检 新辅助治疗 

分 类 号：R6[医药卫生—外科学]