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浙江大学学报(医学版)  2014, Vol. 43 Issue (4): 381-387    DOI: 10.3785/j.issn.1008-9292.2014.07.001
浙江大学医学院附属第二医院肿瘤外科, 浙江 杭州 310009
Prospect and guideline update of sentinel lymph node biopsy for patients with early-stage breast carcinoma
ZHOU Mei-qi, CHEN Hai-long, HU Yue, DENG Yong-chuan, ZHENG Shu
Department of Surgical Oncology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hanghou 310009, China
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Axillary lymph nodes are the most common and initial site of metastasis of breast carcinoma. Precise axillary staging of breast carcinoma before initial treatment is crucial as it allows efficient identification for local and systemic treatment options, and provides prognostic information. Sentinel lymph node biopsy (SLNB) is an accurate minimally invasive technology for axillary staging. Although top evidence of high-quality clinical trials showed that SLNB could safely and effectively replace axillary lymph node dissection (ALND) for axillary negative patients with decrease in complications and improvement in quality of life, there are specific indications and contraindications for SLNB. Clinicians should balance the compliance of guideline and native clinical practice, especially for the circumstance of multifocal/multicentric lesion, breast biopsy history, and neoadjuvant chemotherapy. With the accumulation of clinical practice and new results of clinical trials, axillary therapy has changed from unique surgery to patient-tailored multi-disciplinary intervention, although ALND should be recommended traditionally if SLNB is positive. Intensive and accurate preoperative axillary staging is gradually valued by clinicians. Development of imaging modality especially ultrasonography and ultrasound-guided biopsy can identify some extra lymph node positive patients directly to ALND with avoidance of unnecessary SLNB. Thus, the positive rate of SLNB will decline significantly. It seems possible that axillary management will step into a noninvasive era abandoning SLNB in some patients with small breast cancer. In this article we review the prospect and guideline update of SLNB for patients with early-stage breast cancer.

收稿日期: 2014-06-18


通讯作者: 郑树(1931-),女,教授,博士生导师,主要从事肿瘤基础及临床研究   
Corresponding author: ZHENG Shu,E-mail:   
作者简介: 周美琪(1983-),女,博士研究生,主治医师,主要从事乳腺癌临床和基础研究
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周美琪,等. 早期乳腺癌前哨淋巴结活检临床实践指南更新及展望[J]. 浙江大学学报(医学版), 2014, 43(4): 381-387.
ZHOU Mei-qi,et al. Prospect and guideline update of sentinel lymph node biopsy for patients with early-stage breast carcinoma. Journal of ZheJiang University(Medical Science), 2014, 43(4): 381-387.

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