1枚前哨淋巴结阳性早期乳腺癌保腋窝的可行性分析

目的探讨1枚前哨淋巴结（sentinel lymph node，SLN）阳性的早期乳腺癌患者保腋窝（omitting axillary dissection，OAD）的可行性。方法用美蓝作为示踪剂先行乳腺癌前哨淋巴结活检术（sentinel lymph node biopsy，SLNB），根据快速冰冻病理结果分为SLN阴性组与1枚SLN阳性组，随后两组均行常规腋窝淋巴结清扫（axillary lymph node dissection，ALND）以解剖出非前哨淋巴结（non—sentinellymphnode，NSLN），比较两组间NSLN的阳性率。结果SLN阴性组30例，1例NSLN阳性，阳性率为3．3％，准确性为96．7％（29／30）；1枚SLN阳性组30例，仅3例NSLN阳性，阳性率为10．0％；两组阳性率差异无统计学意义（X^2=1．071，P=0．612）。全组随访1～48个月，均无区域淋巴结复发。结论1枚SLN阳性的早期乳腺癌患者可考虑OAD。

Probablity of omitting axillary dissection in early stage breast cancer with one positive sentinel lymph node

Objective To investigate the probability of omitting axillary dissection（OAD） in patients with early breast cancer with one positive sentinel lymph node （SLN）. Methods The patients with early stage breast cancer underwent sentinel lymph node biopsy （SLNB） with subdermal injection of 2.0 ml methylene blue as tracer agent in the area of areola or aroud incision, they were divided negative SLN group and one positive SLN group. Then axillary lymph node dissection（ALND） were performed in the two groups. The positive rate of non- sentinel lymph node（NSLN） were compared between the two group. Results The NSLN was positive in only one case of negative SLN group （30 cases） , the positive rate was 3.3% , the accuracy was 96.7% （29/30） ; while the NSLN was positive in three cases of one positive SLN group （30 cases） , the positive rate was 10.0%. The positive rates of NSLN were no statistical difference in two groups （X^2 = 1. 071, P = 0. 612）. All the pa- tients were followed up. With a median follow-up of 28 months （1-48 months）, no recurence was in the region lymph nodes. Conculsions OAD is considered in patients with early stage breast cancer with one positive SLN.