重视原发性乳腺癌同期腋淋巴结转移灶生物学标志物的检测

To strengthen the detection of biomarkers in the synchronous metastatic axillary lymph nodes of primary breast cancer

目前乳腺癌术后辅助治疗主要依据原发灶的生物学指标，如ER、PR、HER2等。近年，研究发现同期腋窝淋巴结转移灶与原发灶生物学指标存在一定差异。乳腺癌术后的化疗、内分泌治疗及靶向治疗主要是针对潜在的转移癌细胞，而原发灶不能完全代表潜在转移癌细胞的生物学特性。淋巴转移是乳腺癌最常见的转移途径，作为局部转移的淋巴结转移灶有可能比原发灶更能代表通过腋淋巴结途径转移的潜在的转移癌细胞。因此，有必要结合同期腋淋巴结转移灶及原发灶的受体检测，以便更好的评估术后复发风险和指导治疗，从而为乳腺癌的个体化治疗提供重要理论依据。

Postoperative adjuvant therapy for primary invasive breast cancer patients with synchronous ax- illary metastases is mainly based on the characteristics of biomarker of the primary tumor. Recently, some studies have showed the discordance and clinical significance of estrogen receptor （ER）, progesterone receptor （PR） and human epidermal growth factor receptor 2 （HER2） status between primary breast cancer and synchronous axillary lymph node metastases. As local metastasis, the synchronous axillary metastases may represent the potentially metastatic breast cancer cells much better than the primary tumor. Hence, determination of biomarkers status should be performed in synchronous axillary metastasis, together with primary tumor, to guide therapy management and evaluate the prognosis of primary invasive breast cancer patients with synchronous axillary metastases.