前哨淋巴结活检术预测老年早期乳腺癌腋窝淋巴结转移的价值

目的探讨前哨淋巴结活检术（SLNB）对预测老年Ⅰ、Ⅱ期乳腺癌腋窝淋巴结转移的可行性及准确性。方法选择临床检测腋窝淋巴结阴性的老年Ⅰ、Ⅱ期原发性乳腺癌患者35例,术中在原发肿瘤边缘上、下、左、右选取4个注射点,将1％亚甲蓝注射至距肿瘤边缘0．5cm的皮下组织内,定位腋窝前哨淋巴结并对其进行活检,随后行腋窝淋巴结清扫（ALND）,术后对全部淋巴结行病理检查。结果35例患者中32例检测到前哨淋巴结（检出率为91．43％）,1例出现假阴性。SLN预测腋窝淋巴结状态的敏感性和准确率分别为95．24％、96．87％。结论SLNB基本能准确判断老年早期乳腺癌腋窝淋巴结转移情况,能指导早期乳腺癌腋窝淋巴结清扫范围。

Valuation on sentinel lymph node biopsy for predicting the metastasis of axillary nodes in elder patients with I,II breast cancer

Objective To evaluate the feasibility and accuracy of sentinel lymph node biopsy （SLNB） for predicting the status of axillary lymphnode in in elder patients with Ⅰ, Ⅱ breast cancer. Methods Thirty-five patients with primary early breast cancer of clinical negative axillae were studied. Four sites （up,down,left and fight of primary breast cancer） were selected to inject methylene blue. SEN were localized after injecting methylene primary breast cancer then were biopsied , after that followed by axillary lymph node dissection （AEND）. All of the axillary lymph nodes were valuated pathologically after operation. Results SLN were identified in 32 of 35 ＇cases （91.43%） ,the overall false negative rate of SLNB was 5.00% without any false positive cases ,the sensitivity and accuracy rates of SEN to prediete axillaries nodal status were 95.24% and 96.87% respectively. Conclusions SLNB generally can accurately predict the axillaty lymph metastasis of primary early breast cancer with clinical negative axillae. SLNB is useful to determine the extent of axillary dissection in elder patients with Ⅰ, Ⅱ breast cancer.