关键词: 早期乳腺癌, 放射治疗, 前哨淋巴结, 腋窝淋巴结

Abstract:

Radiotherapeutic strategies for breast cancer patients in accordance with ACOSOG Z0011 study criteria        WANG Yu-jie, CHEN Jia-yi.Department of Radiation Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
Corresponding author: CHEN Jia-yi, E-mail:chenjiayi0188@
aliyun.com
Abstract    Axillary lymph node dissection (ALND)is the standard treatment for patients with sentinel-positive breast cancer, which would increase the risk of adverse outcomes including lymphedema and limited shoulder/arm motion while reducing regional recurrence. Phase Ⅲ ACOSOG Z0011 trial, as a practice-changing study, explored the safety of obviation of ALND among clinical nodal negative patients with 1-2 positive sentinel lymph nodes, providing a new option for axillary management in the group of patients, and bringing new challenges to adjuvant radiotherapy decisions. Although ACOSOG Z0011 and its contemporaries, AMAROS and IBCSG 23-01 studies, have limitations in standard sample size and statistical efficacy, and even in radiotherapy charges, they have confirmed that patients with low load sentinel lymph node metastases can indeed be conditionally relieved  axillary lymph node dissection under different conditions. These studies represents the efforts of breast surgery to reduce axillary surgery injury in the era of modern comprehensive treatment, and also represents the need to re-examine and re-orientate radiotherapy as an important means of local treatment complementary to surgical treatment in the new scientific era.

Key words: early breast cancer, radiotherapy, sentinel lymph node, axillary lymph node