Validation of Sentinel Lymph Node Dissection for Breast Cancer

前哨淋巴結切除術在乳癌治療中的應用

10.6200/TCMJ.2007.4.3.03

陳火木(For-Moon Chen)；李乃信(Nai-Hsin Lee)；陳愫美(Su-Mei Chen)；李勝煌(Sheng-Huang Lee)；張意恆(Yi-Heng Chang)；林家興(Chia-Hsing Lin)；洪碩徽(Shuo-Hui Hung)

前哨淋巴結 ； 乳癌 ； 腋窩淋巴清除術 ； sentinel lymph node ； breast cancer ； axillary lymph node dissection

北市醫學雜誌

4卷3期（2007 / 03 / 01）

219 - 225

英文

目的：驗證在乳癌手術中，以前哨淋巴結切除術取代傳統腋窩淋巴清除術的可行性。方法：在2005年二月到十二月間，對44名乳癌患者以核放射，染料或合併方法進行前哨淋巴清除術。其中驗證組共21位，患者於前哨淋巴結切除術後接著進行傳統腋窩淋巴清除術驗證。其餘23位為前哨淋巴結組，患者只接受前哨淋巴切除術。如果前哨淋巴結無法找到則改行傳統腋窩淋巴清除術。結果：44名患者中有3名無法找到前哨淋巴結，前哨淋巴結發現率為93.2%(41/44)。驗證組中有一名偽陰性，故準確率為95.2%(20/21)，陰性預測值為91.6%。結論：大部分乳癌患者皆可找到前哨淋巴結。在適當選擇的患者，前哨淋巴結可用來預測腋窩淋巴結是否有轉移因此可以避免不必要的腋窩淋巴清除術。

Background and Purpose: Sentinel lymph node dissection has become an alternative to predict axillary lymph node status in breast cancer in recent years. The purpose of this study is to validate this new surgical technique. Methods: From February to December 2005, we have had 44 patients with breast cancer undergo sentinel lymph node dissection in the practice of isotope, blue dye or a combined method. Of the 44 patients, 21 patients received sentinel lymph node dissection followed by complete axillary lymph node dissection and 23 patients would have only received sentinel lymph node biopsy without complete axillary lymph node dissection if sentinel lymph node dissection had been successful. Results: Sentinel lymph nodes can not be found in 3 cases, so the identification rate is 93.2% (41/44). Since there was only one false negative in complete axillary lymph node dissection group, the total accuracy rate turned out to be 95.2% (20/21) and the negative predictive rate was 91.6%. Conclusion: Sentinel lymph node can be identified in most cases and can be used to predict the axillary lymph node status in well-selected cases.