前哨淋巴结活检术替代腋窝淋巴结清扫术在乳腺癌中的临床应用

目的探讨前哨淋巴结活检术（SLNB）替代腋窝淋巴结清扫术（ALND）在早期乳腺癌患者中的应用价值和安全性。方法对2003年1月到2005年12月期间行前哨淋巴结活检术替代腋窝清扫术的125例患者作为研究组，对同一时期行腋窝清扫术且术后病理淋巴结阳性个数≤1的45例患者作为对照组；比较两组患者术后上肢并发症的发生情况及腋窝复发情况。结果SLNB替代ALND术后上肢麻木、肿胀、疼痛、僵硬、上肢活动受限及肌力减退方面的并发症均明显较ALND少，在随访36．5个月中，仅出现一例腋窝复发。结论前哨淋巴结活检术替代腋窝淋巴结清扫术术后并发症明显减少，腋窝复发率低，是早期乳腺癌患者的安全分期手术。

The clinical application of sentinel lymph node biopsy replacing axillary lymph node dissection in breast cancer

Objective To investigate the applied value and safety of the sentinel lymph node biopsy replacing axillary lymph node dissection in breast cancer. Methods From January 2003 to December 2005,125 cases with early satge breast cancer received SLNB replacing ALND were served as study group and 45 cases received ALND and postoperative pathological lymph node positive in the number of zere or one were served as control group at the same time. The postoperative upper limb complications and axillary recurrence were compared between two groups. Results Patients treated with SLNB replacing ALND had less complications in numbness, edema, pain, stiffness, restriction of mobility and myodynamic attenuation of upper limb than those treated with ALND. In the 36.5 moths follow-ups period, there was only one axillary recurrence in SLNB replacing ALND patients. Conclusion SLNB replacing ALND has less complications than ALND and lower axillary recurrence. It is a safe and effective staging operative method for early stage breast cancer.