Extra-axillary sentinel lymph nodes in breast cancer

被引：24

作者：

Harlow S. ^{[1
,4
]}

Krag D. ^{[1
,4
]}

Weaver D. ^{[2
,4
]}

Ashikaga T. ^{[3
,4
]}

机构：

[1] Department of Surgery, University of Vermont, College of Medicine, Burlington, VT 05405-0068

[2] Department of Pathology, University of Vermont, College of Medicine, VT

[3] Department of Biometry, University of Vermont, College of Medicine, VT

[4] Cancer Center, University of Vermont, College of Medicine, VT

来源：

Breast Cancer | 1999年 / 6卷 / 2期

关键词：

Breast cancer; Extra-axillary; Sentinel nodes;

D O I：

10.1007/BF02966925

中图分类号：

学科分类号：

摘要：

Background: Extra-axillary locations are known sites of lymph node metastases in patients with carcinoma of the breast. Methods: A technique utilizing a gamma probe was used to identify hot spots representing sentinel nodes residing in either axillary or extra-axillary locations in 680 patients with operable, clinically nodenegative breast cancer. All identified sentinel nodes were excised. Results: Results showed that extra-axillary hot spots were found in 6.5% of patients. This rate increased to 14.8% if patients were injected with 8.0 ml unfiltered Technetium-99m-Sulfur colloid. Extraaxillary metastatic disease was identified in 6.8% of patients with extra-axillary hot spots. In patients with extra-axillary drainage, pathologically-positive nodes were exclusive to extra-axillary sites (ie, no axillary metastases) in 4.5% of cases. Factors found to increase the likelihood of identifying extra-axillary hot spots included; an increased volume of injection, medial or central tumor locations and T3 primary tumors. Conclusion: Gamma probe-guided techniques can identify extra-axillary sentinel nodes, which are at risk for harboring metastatic disease. Removal of these nodes can be done with little morbidity and may improve staging in the individual patient.

引用

页码：159 / 165

页数：6

共 25 条

[1]

Fleming I., Cooper J., Henson D., Hutter R., Et al., Staging of cancer at anatomic sites

[2]

Breast, Part II, AJCC Cancer Staging Manual, (1997)

[3]

Noguchi M., Miwa K., Michigishi T., Et al., The role of axillary lymph node dissection in breast cancer management, Breast Cancer, 4, pp. 143-153, (1997)

[4]

Morrow M., Role of axillary dissection in breast cancer management, Ann Surg Oncol, 3, pp. 233-234, (1996)

[5]

Fisher B., Redmond C., Fisher E.R., Ten-year results of a randomized clinical trial comparing radical mastectomy and total mastectomy with or without radiation, New England Journal of Medicine, 312, 11, pp. 674-681, (1985)

[6]

Cabanes P., Salmon R., Vilcoq J., Et al., Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer, Lancet, 339, pp. 1245-1248, (1992)

[7]

Hayward J., Caleffi M., The significance of local control in the primary treatment of breast cancer, Archives of Surgery, 122, 11, pp. 1244-1247, (1987)

[8]

Stibbe P., The internal mammary lymphatic glands, Journal of Anatomy, 52, pp. 257-264, (1918)

[9]

Handley R., Thackray A., Invasion of the internal mammary lymph glands in carcinoma of the breast, Br J Cancer, 1, pp. 15-20, (1947)

[10]

Urban J., Radical mastectomy in continuity with enbloc resection of internal mammary lymph node chain

← 1 2 3 →