前哨淋巴结阴性早期乳腺癌射频消融治疗效果初探

Primary study of radiofrequency ablation for early breast cancer with negative sentinel lymph node

目的总结前哨淋巴结(sentinel lymph nodes,SLN)阴性的早期乳腺癌(病灶长径<15 mm)射频消融治疗的初步经验,评估其可行性和疗效。方法纳入2016年10月至2019年11月于郑州大学第一附属医院治疗的早期乳腺癌(病灶长径<15 mm)患者18例,超声造影引导下对腋窝SLN行细针抽吸细胞学(fine needle aspiration cytology,FNAC)检查,腋窝SLN病理阴性者,行乳腺癌射频消融治疗,评估病灶的完全消融率及复发率,观察术中及术后并发症及术后患者满意度。结果18例患者行超声造影引导下腋窝SLN的FNAC检查,阳性者1例,阴性者17例,SLN阴性17例患者(共17个乳腺癌病灶)均行射频消融治疗。病灶长径3.3~14.0(8.2±3.9)mm,消融时间9~18(12.8±2.7)min。术后1个月复查完全消融率为100%,随访9~46个月,无患者出现肿瘤进展。术后均无射频消融相关严重并发症。患者对术后外观的满意度为100%。结论SLN阴性的早期乳腺癌(病灶长径<15 mm)行经皮穿刺射频消融治疗是可行的,具有安全、微创、美观的优势。

Objective To summarize the preliminary experience of percutaneous radiofrequency ablation(RFA)in the treatment of early breast cancer(the length of the lesion<15 mm)with negative sentinel lymph node(SLN),and to evaluate its feasibility and efficacy.Methods From October 2016 to November 2019,18 patients with early breast cancer(the length of the lesion<15 mm)treated in the First Affiliated Hospital of Zhengzhou University underwent FNAC of axillary SLN under the guidance of CEUS were enrolled.Patients with pathologically negative axillary SLN were treated with percutaneous RFA of breast cancer.The complete ablation rate and the relapse rate were evaluated.Intraoperative pain,postoperative complications and postoperative patient satisfaction were analyzed.Results Eighteen patients underwent CEUS-guided FNAC of SLN,of which 1 case was positive and 17 cases were negative.Seventeen breast cancer lesions of the 17 negative patients underwent percutaneous RFA.The length of the lesions was 3.3-14.0(8.2±3.9)mm,the complete ablation rate was 100%,the ablation time was 9-18(12.8±2.7)min.During the follow-up of 9-46 months,no patient developed tumor progression.There were no serious complications related to RFA after operation.The patients′satisfactory rate for postoperative appearance was 100%.Conclusions RFA of early breast cancer(the length of the lesion<15 mm)with negative SLN is feasible and has the advantages of safety,minimal invasion and beauty.