摘要
目的通过对乳腺癌患者前哨淋巴结转移与原发肿瘤大小相关性分析,探讨T1期乳腺癌保留乳房手术中不行腋窝淋巴结干预的可行性。方法回顾性分析2009-01-01-2014-01-31沧州市人民医院收治76例临床腋窝淋巴结阴性的T1期乳腺癌患者的临床资料,均实施保留乳房手术＋亚甲蓝示踪法前哨淋巴结活组织检查术,分析肿瘤大小与前哨淋巴结转移及预后的关系。结果 76例患者中,1例未行腋窝淋巴结干预。75例行前哨淋巴结活组织检查,前哨淋巴结示踪成功率为97.3%（73/75）,腋窝淋巴结转移率为8.0%（6/75）。肿瘤直径≤1cm组共39例,前哨淋巴结阳性率为0（0/39）;肿瘤直径〉1cm且≤2cm组共36例,前哨淋巴结阳性率为16.7%（6/36）,两组患者前哨淋巴结阳性率比较差异有统计学意义,P〈0.05。全部病例均获随访,随访时间6~69个月,中位随访时间32个月,均无复发及转移。结论对临床与影像学检查提示腋窝淋巴结阴性的T1期乳腺癌患者,当原发肿瘤直径≤1cm时,腋窝淋巴结转移的概率极低,在保留乳房手术治疗时,可以免行前哨淋巴结活组织检查术。由于样本量少,且没有远期随访结果,仍需要进一步深入研究。
OBJECTIVE To analyze the correlation between sentinel lymph node metastasis and primary tumor size and axillary lymph node metastasis in breast cancer,and to explore the feasibility of no axillary lymph node intervention of breast conserving operation in stage T1 breast cancer.METHODS Retrospective analyze the clinical data of 76 patients with stage T1 breast cancer,whose clinical axillary lymph node were negative and underwent breast conserving operation plus methylene blue method of sentinel lymph node（SLN）biopsy in our hospital from 1st January 2009 to 31st January2014.The patients were closely followed-up with recurrence and metastasis,and the relationship between the size of tumor and the sentinel lymph node metastasis was analyzed.RESULTS Among the 76 patients,1patients had done no axillary lymph node interference,75 patients underwent sentinel lymph node biopsy,sentinel lymph node tracer success rate was 97.3%（73/75）,axillary lymph node metastasis rate was 8.0%（6/75）.The tumor diamete was less than or equal to 1cm group of 39 cases,the positive rate of sentinel lymph nodes was 0（0/39）.The tumor diameter between 1cm and 2cm were in 36 cases,the positive rate of sentinel lymph nodes was 16.7%（6/36）.There was significant difference between the two groups（P〈0.05）.The patients were followed up for 6-69 months,the median follow-up time was32 months,no recurrence and metastasis was found.CONCLUSIONS On clinical and radiologic examination revealed axillary lymph node negative T1 breast cancer patients,when the primary tumor diameter is less than or equal to 1cm,axillary lymph node metastasis probability is very low,in the treatment of breast conserving operation,seems to be free for sentinel lymph node biopsy.Because the sample size is small,and there is no long-term follow-up results,it still needs to be further studied.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2016年第2期84-87,共4页
Chinese Journal of Cancer Prevention and Treatment
关键词
乳腺肿瘤
T1期
保留乳房手术
亚甲蓝
前哨淋巴结活组织检查
breast neoplasms
stage T1
breast conserving operation
methylene blue
sentinel lymph node biopsy
