유방암환자에서 감시 림프절 생검의 임상적 경험

Abstract

Axillary nodal status is the single most important predictor of disease outcome in patients with breast cancer and also the best guide for adjuvant therapy. Sentinel lymph node biopsy (SLN) is an established, minimally invasive means of staging the axilla in patients with breast cancer. We did a retrospective analysis to evaluate the success rate, sensitivity, false negative rate of SLN localization in early breast caner. A retrospective annalysis was performed of 223 breast cancer patients who underwent SLN biopsy with radiopharmaceutical and blue dye for SLN identification from December 1998 to June 2005. All SLNs were submitted for intraoperative frozen section analysis, touch preparation, and hematoxylin and eosin stain. The mean age at diagnosis was 48.56 years, the mean tumor size was 1.98cm, and the mean number of SLNs was 1.4. The detection rate of SLN through whole period with both agent was 97.2%, the sensitivity 96.2% and false negative rate 3.8%. The detection rate and the false negative rate had improved after thd learning period. The false negative rate for tumors less the 2 cm was significantly lower than that for tumors greater than 2 cm. The addition of a radiopharmaceutical and the dye in SLN biopsy inceases the detection rate of SLNs in breast cancer patients after learning period and SLN biospy may be applicable to breast cancer patients and thereby allow the omission of routine axillary dissection in selected cases.