Is sentinel node biopsy necessary in the radiologically negative axilla in breast cancer?

被引：25

作者：

Jozsa, Felix ^{[1
]}

Ahmed, Muneer ^{[1
]}

Baker, Rose ^{[2
]}

Douek, Michael ^{[3
]}

机构：

[1] Kings Coll London, Div Canc Studies, Res Oncol, London SE1 9RT, England

[2] Univ Salford, Sch Business, Dept Stat, 612 Maxwell Bldg, Salford M5 4WT, Lancs, England

[3] Univ Oxford, Botnar Res Ctr, Nuffield Dept Surg Sci, Oxford OX3 7LD, England

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2019年 / 177卷 / 01期

关键词：

Axillary ultrasound; Axillary node metastasis; Sentinel node biopsy; Axillary node clearance; Axillary conservatism; DISSECTION; ULTRASOUND; IMPACT;

D O I：

10.1007/s10549-019-05299-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PurposeThe steady move towards axillary conservatism in breast cancer is based on studies demonstrating that axillary node clearance affords no survival benefit in a subset of patients with a positive pre-operative axillary ultrasound (AUS). However, less attention has been paid to AUS-negative patients who receive sentinel node biopsy as standard.MethodsPreviously assembled systematic review data was reassessed to evaluate nodal burden amongst patients with breast cancer and a clinically and radiologically negative axilla.ResultsPooled data from four cohort studies reporting pre-operative axillary ultrasound in 5139 patients with breast cancer show it has a negative predictive rate of 0.951 (95% confidence interval 0.941-0.960).ConclusionsReconsidering the use of ultrasound in patients with early breast cancer and non-palpable axillae reveals that sentinel node biopsy itself may represent surgical over-treatment in patients with a negative axillary ultrasound. The implications of this on the future of surgical management of the axilla are discussed.

引用

页码：1 / 4

页数：4

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