Purpose:Marker placement in a pathological node improves extirpation rates in breast cancer cases with limited axillary involvement. Our goal was to assess the current indications for seed-marked axillary lymph node dissection (SMALND).Methods:We conducted a descriptive observational study, including 93 patients with cN1 breast cancer treated between January 2019 and December 2023. Seed placement was performed under ultrasound guidance, days before the procedure. Intraoperative detection was achieved using a probe, and resection was confirmed radiologically.Results:The primary indication was post-neoadjuvant therapy (72 patients: 60 for chemotherapy and 12 for hormone therapy), followed by initial surgery (14) and a single axillary recurrence (8). The extirpation rate of the marked axillary lymph node was 100%. In targeted axillary dissection (TAD), the concordance rate between the sentinel node and the marked axillary node was 85%. In the 12 cases of initial surgery, axillary lymphadenectomy was avoided because the marked node matched the sentinel node and was the only one involved.Conclusions:The use of seeds was proven to be highly useful in axillary surgery, both in cases of negativization following neoadjuvant therapy and in those with low axillary involvement or a single axillary recurrence.
目的：在腋窝受累有限的乳腺癌病例中，对病理淋巴结进行标记物放置可提高切除率。本研究旨在评估当前种子标记腋窝淋巴结清扫术（SMALND）的适应症。 方法：我们开展了一项描述性观察研究，纳入2019年1月至2023年12月期间收治的93例cN1期乳腺癌患者。术前数日在超声引导下放置放射性种子，术中通过探测器进行定位，并经影像学确认切除效果。 结果：主要适应症为新辅助治疗后（72例：其中化疗60例，激素治疗12例），其次为初始手术（14例）和单发腋窝复发（8例）。标记腋窝淋巴结的切除率达到100%。在靶向腋窝清扫术（TAD）中，前哨淋巴结与标记腋窝淋巴结的符合率为85%。在12例初始手术中，因标记淋巴结与前哨淋巴结相符且为唯一受累淋巴结，从而避免了腋窝淋巴结清扫。 结论：研究证实，放射性种子在腋窝手术中具有重要应用价值，既适用于新辅助治疗后淋巴结转阴的病例，也适用于腋窝低负荷受累或单发腋窝复发的病例。
Current Indications for Seed-Marked Axillary Lymph Node Dissection in Breast Cancer
肿瘤(癌症)患者之家