乳腺癌新辅助治疗后前哨淋巴结活检术应用的研究进展

腋窝淋巴结清扫术(axillary lymph node dissection,ALND)是新辅助治疗(neoadjuvant treatment,NAT)后腋窝淋巴结标准的处理方式.然而,ALND不能使NAT后腋窝淋巴结病理性完全缓解(pathologic complete response,pCR)的患者获益.现已证实,对于临床诊断腋窝淋巴结阴性(cN0)患者,前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)可对其腋窝淋巴结进行准确评估,使部分患者免于接受ALND.目前多家研究机构着力将SLNB引入NAT后cN0的乳腺癌的治疗中,并在提高其检出率,降低假阴性率等方面获得了长足的进步.本文对近年来SLNB应用于NAT后cN0乳腺癌治疗的相关研究成果及诸多用于提高其准确性的方法进行阐述.

Research progress of sentinel lymph node biopsy after neoadjuvant therapy in breast cancer

The standard treatment of the axilla after NAT has been an ALND.However,ALND would not bring benefit to patients whose axillary lymph nodes become pCR after NAT.It has now been confirmed that SLNB can be accurately assess the axillary lymph nodes for those the clinical diagnosis of axillary lymph nodes is negative(cN0),making some of them from accepting ALND.Presently,several research institutions focus on introducing SLNB into the treatment of cN0 breast cancer after NAT and have gained great progress in improving the detection rate and lowering the false negative rate.This paper will describe the application of SLNB in the treatment of breast cancer patients with cN0 after neoadjuvant chemotherapy and many related research results used to improve the accuracy of the method in recent years.