Discussion on the indications of internal mammary sentinel lymph node biopsy in breast cancer in the era of precision medicine
10.3760／cma.j.issn.0253?3766.2019.04.003
- VernacularTitle:精准医学时代乳腺癌内乳前哨淋巴结活检适应证的探讨
- Author:
Yongsheng WANG
1
;
Rongrong ZHAO
;
Yanbing LIU
;
Peng CHEN
;
Tong ZHAO
;
Xiao SUN
;
Chunjian WANG
;
Zhaopeng ZHANG
;
Zhiqiang SHI
;
Pengfei QIU
Author Information
1. 山东大学附属山东省肿瘤医院乳腺病中心
- Keywords:
[Subject words] Breast neoplasms;
Internal mammary sentinel lymph node biopsy;
Axillary lymph node
- From:
Chinese Journal of Oncology
2019;41(4):251-256
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM?SLNB) acquired by breast cancer patients with clinically positive axillary lymph node ( ALN), and further optimize the IM?SLNB indications. Methods All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study.IM?SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM?SLNB, metastatic rate of internal mammary sentinel lymph node ( IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines. Results Among 126 patients, all of 94 patients ( 74.6%) who showed internal mammary drainage successfully underwent IM?SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%( 4／94) and 9.6%(9／94), respectively. The metastatic rate of IMSLN was 38.3%( 36／94), which was significantly associated with the number of positive ALN (P＜0.001) and tumor size (P＝0.024).The lymph node staging of 94 patients who underwent IM?SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy. Conclusions IM?SLNB should be routinely performed in patients with positive ALN. IM?SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.
