中国实用外科杂志

中国实用外科杂志

• 普通外科进展 • 上一篇    下一篇

乳腺癌行腋窝淋巴结清扫规范、争议与共识

马    榕，张    凯   

  1. 山东大学齐鲁医院乳腺外科，山东济南250012
  • 出版日期:2015-01-01 发布日期:2014-12-31

  • Online:2015-01-01 Published:2014-12-31

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摘要：

乳腺癌的有效治疗方法很多，但外科手术是公认的乳腺癌治疗的基础。手术成功与否的最根本标志是肿瘤手术区域的局部控制。腋窝淋巴结受累的程度是预测乳腺癌术后复发和生存，指导进一步个体化治疗的最为重要指标。规范的腋窝淋巴结清扫和病理检查对乳腺癌的治疗至关重要。术前判断存在腋窝淋巴结转移的乳腺癌病人，腋窝淋巴结清扫是乳腺癌手术的规范和要求。术前临床诊断无腋窝淋巴结转移（cN0）的早期乳腺癌病人，如果前哨淋巴结活检阴性可不做进一步的腋窝淋巴结清扫也已成为共识。对于前哨淋巴结1或2枚阳性的乳腺癌病人可以不行腋窝淋巴结的清扫的观点仍然存在争论。

关键词: 乳腺癌, 腋窝淋巴结清扫, 前哨淋巴结活检

Abstract:

Standard, controversy and consensus of axillary lymph nodes dissection in breast cancer        MA Rong, ZHANG Kai. Department of Breast Surgery, Qilu Hospital of Shandong University, Jinan 250012, China
Corresponding author: MA Rong, E-mail: marongw2000@163.com
Abstract    There are many effective methods for breast cancer treatment, surgery is the basis of management of breast cancer. Local control is the symbol of a successful operation. Lymph node status is not only the most important factor in predicting survival in breast cancer, but also the guider of further treatment. Axillary lymph node dissection and pathological examination remains standard management of the axilla and assessment of breast cancer patients. For clinical axillary lymph node metastasis patients, axillary lymph node dissection is critical. Sentinel lymph node biopsy has become standard care for management of the axilla in clinical axillary node-negative early breast cancer patients. It is clear that axillary lymph node dissection should be strongly considered in the management of the sentinel lymph node positive axilla. Omission of axillary lymph node dissection for breast cancer patients with 1-2 positive sentinel lymph nodes is still controversial .

Key words: breast cancer, axillary lymph nodes dissection, sentinel lymph node biopsy