乳腺癌伴1~2枚前哨淋巴结转移腋窝外科处理的研究进展  

Advances in Axillary Surgical Management of Breast Cancer with One or Two Sentinel Lymph Node Metastases

作　　者：黄珍 谢玉洁 李黎荟 潘音桦[1] 黄栋[1] 刘媛[3] 何向明 邹全庆[1] 杨建荣[5] HUANG Zhen;XIE Yu-jie;LI Li-hui;PAN Yin-hua;HUANG Dong;LIU Yuan;HE Xiang-ming;ZOU Quan-qing;YANG Jian-rong(People’s Hospital of Guangxi Zhuang Autonomous Region,Guangxi Academy of Medical Sci-ences,Nanning 530022,China;Graduate School of Guangxi Medical University,Nanning 530021,China;Liuzhou Workers’Hospital,Liuzhou 545005,China;The Cancer Hospital of the University of Chinese Academy of Sciences(Zhejiang Cancer Hospital),Institute of Basic Medicine and Cancer(IBMC),Chinese Academy of Sciences,Hangzhou 310022,China)

机构地区：[1]广西壮族自治区人民医院,广西医学科学院,广西南宁530022 [2]广西医科大学研究生学院,广西南宁530021 [3]柳州市工人医院,广西柳州545005 [4]中国科学院大学附属肿瘤医院(浙江省肿瘤医院),中国科学院基础医学与肿瘤研究所,浙江杭州310022 [5]广西壮族自治区人民医院乳腺甲状腺外科,广西南宁530022

出　　处：《肿瘤学杂志》2021年第12期991-996,共6页Journal of Chinese Oncology

基　　金：广西壮族自治区卫生健康委自筹经费科研课题(z20200134)。

摘　　要：乳腺癌腋窝手术对确立临床分期、辅助治疗选择及预后判断均有重要价值。临床淋巴结阴性的乳腺癌,应用前哨淋巴结活检(SLNB)确定腋窝淋巴结分期已成为标准。对于前哨淋巴结(SLN)阴性的乳腺癌,腋窝淋巴结清扫(ALND)可以避免;而对于SLN阳性的乳腺癌,ALND仍是标准的腋窝处理方式。然而,在SLN阳性患者中进一步行ALND后发现,在仅1~2枚SLN阳性患者中,61.4%~64.5%非前哨淋巴结(nSLN)为阴性。已有大量的临床研究探索了特定条件下的1~2枚SLN阳性患者免除ALND的可行性与安全性。全文就乳腺癌伴1~2枚SLN转移腋窝外科处理的相关研究进行综述。Axillary surgery for breast cancer is of great value in determining clinical stage, adjuvant treatment and prognosis. In clinically lymph node-negative breast cancer, the use of sentinel lymph node biopsy(SLNB) to determine axillary lymph node staging has become the standard protocol. For sentinel lymph node(SLN) negative breast cancer, axillary lymph node dissection(ALND) can be avoided;while for SLN positive breast cancer, ALND is still the standard axillary treatment. However, it has been revealed that in patients with only one or two positive SLN, 61.4% to 64.5% non-sentinel lymph nodes(nSLN) were negative as shown by further ALND. A large number of clinical studies have explored the feasibility and safety of ALND exemption in one or two SLN positive patients under certain conditions. This article reviews the recent progress on the surgical management of breast cancer with one or two SLN metastases.

关 键 词：乳腺肿瘤 前哨淋巴结活检 腋窝淋巴结清扫 

分 类 号：R737.9[医药卫生—肿瘤]