乳腺导管内癌前哨淋巴结活检术的临床意义

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

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。

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 DC/SM patients. Coaeluslon： 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.