乳腺导管内癌前哨淋巴结活检术的临床意义

  目的  探讨乳腺导管内癌(DCIS)患者接受前哨淋巴结活检术(SLNB)的临床意义。  方法  回顾性分析2002年1月至2011年5月来自全国13家医院的325例接受SLNB的乳腺癌患者的临床资料, 其中DCIS患者237例, 导管内癌伴微浸润(DCISM)患者88例, 分析前哨淋巴结(SLN)的阳性率及其影响因素等指标。  结果  325例患者的SLN阳性率为6.15%。237例DCIS患音的SLN阳性率为3.80%, 超声示肿瘤较大和高组织学分级的患者SLN阳性率较高。88例DCISM患者阳性率为12.5%, 年轻患者SLN阳性率较高。  结论  DCISM患者需要接受SLNB, 接受乳房切除术的DCIS患者需要同时接受SLNB, 接受保乳手术的DCIS患者可以不同时接受SLNB, 但高度怀疑存在浸润成分的DCIS患者建议接受SLNB 

Sentinel Lymph Node Biopsy in Patients with Breast Ductal Carcinoma in situ

  Objective  This study aims to evaluate the roles of sentinel lymph node biopsy(SLNB)in patients with breast ductal carcinoma in situ(DCIS).  Methods  The database of 13 multi-centers on 237 breast DCIS patients and 88 breast ductal carcinoma in situ with micro-invasion(DCISM)patients who received SLNB from January 2002 to May 2011 was retrospectively analyzed.  Results  The sentinel lymph node(SLN)positive rate of the 325 patients was 6.15%.Among the 237 DCIS patients, the positive rate was 3.8%, and the rate was higher in patients with ultrasound-diagnosed large tumors or high histologic grade tumors.Among the 88 DCISM patients, the positive rate was 12.5%, and the rate was higher in younger DCISM patients.  Conclusion  SLNB should be performed in all DCISM patients and in DCIS patients who received mastectomy.This procedure could be avoided in patients who received breast-conserving surgery. However, SLNB should be recommended to patients who have high risks for laboring invasive components.