Current Status and Advances of Sentinel Lymph Node Biopsy in Breast Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHEN Xiang ^1,2 ,  WANG Shui ¹

1.Department of General Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China;;
2.Department of General Surgery, The Yixing People’s Hospital, Yixing 214200, Jiangsu Province, China;

Corresponding author：

WANG Shui, Email: ws0801@hotmail.com

Keywords：

Breast cancer; Axillary lymph node dissection; Sentinel lymph node biopsy; False negative; False positive

Video：

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ObjectiveTo summarize the current status and advances of sentinel lymph node biopsy (SLNB) technique in breast cancer. MethodsThe pertinent domestic and overseas literatures were reviewed and the localization, harvest, status assessment, indications, and complications of SLNB were analyzed. ResultsSLNB could accurately locate and pick out sentinel lymph node (SLN) in breast cancer. The development on imaging examination and pathological techniques promoted the assessment of SLN, and the indications of SLNB were expanding. The complication rate of SLNB was low and the technique could accurately predict axillary lymph node staging and direct selective axillary lymph node dissection. ConclusionsSLNB has been an important method of surgical therapy in breast cancer, but the operation process needs to be further standardized to decrease the false negative rate. Continuative attentions shall be paid to the problems such as the false positive and controversial indications.

Citation： CHEN Xiang ,WANG Shui. Current Status and Advances of Sentinel Lymph Node Biopsy in Breast Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(1): 98-102. doi: Copy

1.	马宏岩. 乳腺癌微创治疗的研究进展 [J]. 中国普外基础与临床杂志, 2010, 17(3): 214218.
2.	Takei H, Kurosumi M, Yoshida T, et al. Current trends of sentinel lymph node biopsy for breast cancer－a surgeon’s perspective [J]. Breast Cancer, 2007, 14(4): 362370.
3.	Varghese P, AbdelRahman AT, Akberali S, et al. Methylene blue dye－a safe and effective alternative for sentinel lymph node localization [J]. Breast J, 2008, 14(1): 6167.
4.	McMasters KM, Tuttle TM, Carlson DJ, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multiinstitutional practice when optimal technique is used [J]. J Clin Oncol, 2000, 18(13): 25602566.
5.	Mudun A, Sanli Y, Ozmen V, et al. Comparison of different injection sites of radionuclide for sentinel lymph node detection in breast cancer: single institution experience [J]. Clin Nucl Med, 2008, 33(4): 262267.
6.	Mathew MA, Saha AK, Saleem T, et al. Preoperative lymphoscintigraphy before sentinel lymph node biopsy for breast cancer [J]. Breast, 2010, 19(1): 2832.
7.	陈翔, 王水, 刘晓安, 等. 前哨淋巴结活检指导保留乳房手术患者行选择性腋窝淋巴结清扫的研究 [J]. 中华乳腺病杂志（电子版）, 2010, 4(3): 1013.
8.	Somasundaram SK, Chicken DW, Keshtgar MR. Detection of the sentinel lymph node in breast cancer [J]. Br Med Bull, 2007, 84(1): 117131.
9.	Taback B, Hashimoto K, Kuo CT, et al. Molecular lymphatic mapping of the sentinel lymph node [J]. Am J Pathol, 2002, 161(4): 11531161.
10.	Livingston SF, Arlen M. The extended extrapleural radical mastectomy: its role in the treatment of carcinoma of the breast [J]. Ann Surg, 1974, 179(3): 260265.
11.	Gaffney DK, Tsodikov A, Wiggins CL. Diminished survival in patients with inner versus outer quadrant breast cancers [J]. J Clin Oncol, 2003, 21(3): 467472.
12.	Cranenbroek S, van der Sangen MJ, Kuijt GP, et al. Diagnosis, treatment and prognosis of internal mammary lymph node recurrence in breast cancer patients [J]. Breast Cancer Res Treat, 2005, 89(3): 271275.
13.	Chen RC, Lin NU, Golshan M, et al. Internal mammary nodes in breast cancer: diagnosis and implications for patient management－a systematic review [J]. J Clin Oncol, 2008, 26(30): 49814989.
14.	Chen L, Gu Y, Leaw S, et al. Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer [J]. BMC Cancer, 2010, 10: 479.
15.	Noguchi M, Kurosumi M, Iwata H, et al. Clinical and pathologic factors predicting axillary lymph node involvement in breast cancer [J]. Breast Cancer, 2000, 7(2): 114123.
16.	Ueda S, Tsuda H, Asakawa H, et al. Utility of 18Ffluorodeoxyglucose emission tomography/computed tomography fusion imaging (18FFDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer [J]. BMC Cancer, 2008, 8: 165.
17.	Torigian DA, Huang SS, Houseni M, et al. Functional imaging of cancer with emphasis on molecular techniques [J]. CA Cancer J Clin, 2007, 57(4): 206224.
18.	Yamamoto S, Maeda N, Tamesa M, et al. Sentinel lymph node detection in breast cancer patients by realtime virtual sonography constructed with threedimensional computed tomographylymphography [J]. Breast J, 2010, 16(1): 48.
19.	Rao R, Lilley L, Andrews V, et al. Axillary staging by percutaneous biopsy: sensitivity of fineneedle aspiration versus core needle biopsy [J]. Ann Surg Oncol, 2009, 16(5): 11701175.
20.	Feng J, Bernacki EG. Intraoperative cytologic evaluation of sentinel lymph nodes in patients with breast carcinoma by scrape preparation [J]. Diagn Cytopathol, 2008, 36(11): 790793.
21.	Horvath JW, Barnett GE, Jimenez RE, et al. Comparison of intraoperative frozen section analysis for sentinel lymph node biopsy during breast cancer surgery for invasive lobular carcinoma and invasive ductal carcinoma [J]. World J Surg Oncol, 2009, 7: 34.
22.	Krishnamurthy S, MericBernstam F, Lucci A, et al. A prospective study comparing touch imprint cytology, frozen section analysis, and rapid cytokeratin immunostain for intraoperative evaluation of axillary sentinel lymph nodes in breast cancer [J]. Cancer, 2009, 115(7): 15551562.
23.	Julian TB, Blumencranz P, Deck K, et al. Novel intraoperative molecular test for sentinel lymph node metastases in patients with earlystage breast cancer [J]. J Clin Oncol, 2008, 26(20): 33383345.
24.	Tan LK, Giri D, Hummer AJ, et al. Occult axillary node metastases in breast cancer are prognostically significant: results in 368 nodenegative patients with 20year followup [J]. J Clin Oncol, 2008, 26(11): 18031809.
25.	Cox CE, Kiluk JV, Riker AI, et al. Significance of sentinel lymph node micrometastases in human breast cancer [J]. J Am Coll Surg, 2008, 206(2): 261268.
26.	de Boer M, van Deurzen CH, van Dijck JA, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer [J]. N Engl J Med, 2009, 361(7): 653663.
27.	Veronesi U, Luini A, Galimberti V, et al. Extent of metastatic axillary involvement in 1 446 cases of breast cancer [J]. Eur J Surg Oncol, 1990, 16(2):127133.
28.	Xu X, Roberts SA, Pasha TL, et al. Undesirable cytokeratin immunoreactivity of native nonepithelial cells in sentinel lymph nodes from patients with breast carcinoma [J]. Arch Pathol Lab Med, 2000, 124(9): 13101313.
29.	Youngson BJ, Liberman L, Rosen PP. Displacement of carcinomatous epithelium in surgical breast specimens following stereotaxic core biopsy [J]. Am J Clin Pathol, 1995, 103(5): 598602.
30.	Bleiweiss IJ, Nagi CS, Jaffer S. Axillary sentinel lymph nodes can be falsely positive due to iatrogenic displacement and transport of benign epithelial cells in patients with breast carcinoma [J]. J Clin Oncol, 2006, 24(13): 20132018.
31.	National Comprehensive Cancer Network: NCCN clinical practice guidelines in oncology. Breast Cancer. v 2. 2008 [EB/OL]. http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf.
32.	Virnig BA, Tuttle TM, Shamliyan T, et al. Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes [J]. J Natl Cancer Inst, 2010, 102(3): 170178.
33.	Tada K, Ogiya A, Kimura K, et al. Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer [J]. World J Surg Oncol, 2010, 8: 6.
34.	van la Parra RF, Ernst MF, Barneveld PC, et al. The value of sentinel lymph node biopsy in ductal carcinoma in situ (DCIS) and DCIS with microinvasion of the breast [J]. Eur J Surg Oncol, 2008, 34(6): 631635.
35.	Yen TW, Hunt KK, Ross MI, et al. Predictors of invasive breast cancer in patients with an initial diagnosis of ductal carcinoma in situ: a guide to selective use of sentinel lymph node biopsy in management of ductal carcinoma in situ [J]. J Am Coll Surg, 2005, 200(4): 516526.
36.	Schrenk P, Hochreiner G, Fridrik M, et al. Sentinel node biopsy performed before preoperative chemotherapy for axillary lymph node staging in breast cancer [J]. Breast J, 2003, 9(4): 282287.
37.	Gimbergues P, Abrial C, Durando X, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy is accurate in breast cancer patients with a clinically negative axillary nodal status at presentation [J]. Ann Surg Oncol, 2008, 15(5): 13161321.
38.	Holwitt DM, Gillanders WE, Aft RL, et al. Sentinel lymph node biopsy in patients with multicentric/multifocal breast cancer: low falsenegative rate and lack of axillary recurrence [J]. Am J Surg, 2008, 196(4): 562565.
39.	Knauer M, Konstantiniuk P, Haid A, et al. Multicentric breast cancer: a new indication for sentinel node biopsy-a multiinstitutional validation study [J]. J Clin Oncol, 2006, 24(21): 33743380.
40.	D’Eredita’ G, Giardina C, Ingravallo G, et al. Sentinel lymph node biopsy in multiple breast cancer using subareolar injection of the tracer [J]. Breast, 2007, 16(3): 316322.
41.	Boughey JC, Khakpour N, MericBernstam F, et al. Selective use of sentinel lymph node surgery during prophylactic mastectomy [J]. Cancer, 2006， 107(7): 14401447.
42.	Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in earlystage breast cancer [J]. J Clin Oncol, 2005, 23(30): 77037720.
43.	Rodriguez Fernandez J, Martella S, Trifirò G, et al. Sentinel node biopsy in patients with previous breast aesthetic surgery [J]. Ann Surg Oncol, 2009, 16(4): 989992.
44.	Intra M, Trifirò G, Galimberti V, et al. Second axillary sentinel node biopsy for ipsilateral breast tumour recurrence [J]. Br J Surg, 2007, 94(10): 12161219.
45.	PanditTaskar N, Dauer LT, Montgomery L, et al. Organ and fetal absorbed dose estimates from 99Tcmsulfur colloid lymphoscintigraphy and sentinel node localization in breast cancer patients [J]. J Nucl Med, 2006, 47(7): 12021208.
46.	Yen TW, Fan X, Sparapani R, et al. A contemporary, populationbased study of lymphedema risk factors in older women with breast cancer [J]. Ann Surg Oncol, 2009, 16(4): 979988.
47.	Cox CE, Dupont E, Whitehead GF, et al. Age and body mass index may increase the chance of failure in sentinel lymph node biopsy for women with breast cancer [J]. Breast J, 2002, 8(2): 8891.
48.	Jinno H, Ikeda T, Asaga S, et al. Increasing age does not affect efficacy of sentinel lymph node biopsy using smallersized technetium99m tin colloids for breast cancer patients [J]. Am J Surg, 2005, 190(1): 5154.
49.	Wang J, Kollias J, Marsh C, et al. Are males with early breast cancer treated differently from females with early breast cancer in Australia and New Zealand? [J]. Breast, 2009, 18(6): 378381.
50.	Gentilini O, Chagas E, Zurrida S, et al. Sentinel lymph node biopsy in male patients with early breast cancer [J]. Oncologist, 2007, 12(5): 512515.
51.	Purushotham AD, Upponi S, Klevesath MB, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial [J]. J Clin Oncol, 2005, 23(19): 43124321.
52.	CraneOkada R, Wascher RA, Elashoff D, et al. Longterm morbidity of sentinel node biopsy versus complete axillary dissection for unilateral breast cancer [J]. Ann Surg Oncol, 2008, 15(7): 19962005.
53.	王永胜. 乳腺癌前哨淋巴结活检: 共识与展望 [J]. 中国普外基础与临床杂志, 2009, 16(7): 505509.

1. 马宏岩. 乳腺癌微创治疗的研究进展 [J]. 中国普外基础与临床杂志, 2010, 17(3): 214218.
2. Takei H, Kurosumi M, Yoshida T, et al. Current trends of sentinel lymph node biopsy for breast cancer－a surgeon’s perspective [J]. Breast Cancer, 2007, 14(4): 362370.
3. Varghese P, AbdelRahman AT, Akberali S, et al. Methylene blue dye－a safe and effective alternative for sentinel lymph node localization [J]. Breast J, 2008, 14(1): 6167.
4. McMasters KM, Tuttle TM, Carlson DJ, et al. Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multiinstitutional practice when optimal technique is used [J]. J Clin Oncol, 2000, 18(13): 25602566.
5. Mudun A, Sanli Y, Ozmen V, et al. Comparison of different injection sites of radionuclide for sentinel lymph node detection in breast cancer: single institution experience [J]. Clin Nucl Med, 2008, 33(4): 262267.
6. Mathew MA, Saha AK, Saleem T, et al. Preoperative lymphoscintigraphy before sentinel lymph node biopsy for breast cancer [J]. Breast, 2010, 19(1): 2832.
7. 陈翔, 王水, 刘晓安, 等. 前哨淋巴结活检指导保留乳房手术患者行选择性腋窝淋巴结清扫的研究 [J]. 中华乳腺病杂志（电子版）, 2010, 4(3): 1013.
8. Somasundaram SK, Chicken DW, Keshtgar MR. Detection of the sentinel lymph node in breast cancer [J]. Br Med Bull, 2007, 84(1): 117131.
9. Taback B, Hashimoto K, Kuo CT, et al. Molecular lymphatic mapping of the sentinel lymph node [J]. Am J Pathol, 2002, 161(4): 11531161.
10. Livingston SF, Arlen M. The extended extrapleural radical mastectomy: its role in the treatment of carcinoma of the breast [J]. Ann Surg, 1974, 179(3): 260265.
11. Gaffney DK, Tsodikov A, Wiggins CL. Diminished survival in patients with inner versus outer quadrant breast cancers [J]. J Clin Oncol, 2003, 21(3): 467472.
12. Cranenbroek S, van der Sangen MJ, Kuijt GP, et al. Diagnosis, treatment and prognosis of internal mammary lymph node recurrence in breast cancer patients [J]. Breast Cancer Res Treat, 2005, 89(3): 271275.
13. Chen RC, Lin NU, Golshan M, et al. Internal mammary nodes in breast cancer: diagnosis and implications for patient management－a systematic review [J]. J Clin Oncol, 2008, 26(30): 49814989.
14. Chen L, Gu Y, Leaw S, et al. Internal mammary lymph node recurrence: rare but characteristic metastasis site in breast cancer [J]. BMC Cancer, 2010, 10: 479.
15. Noguchi M, Kurosumi M, Iwata H, et al. Clinical and pathologic factors predicting axillary lymph node involvement in breast cancer [J]. Breast Cancer, 2000, 7(2): 114123.
16. Ueda S, Tsuda H, Asakawa H, et al. Utility of 18Ffluorodeoxyglucose emission tomography/computed tomography fusion imaging (18FFDG PET/CT) in combination with ultrasonography for axillary staging in primary breast cancer [J]. BMC Cancer, 2008, 8: 165.
17. Torigian DA, Huang SS, Houseni M, et al. Functional imaging of cancer with emphasis on molecular techniques [J]. CA Cancer J Clin, 2007, 57(4): 206224.
18. Yamamoto S, Maeda N, Tamesa M, et al. Sentinel lymph node detection in breast cancer patients by realtime virtual sonography constructed with threedimensional computed tomographylymphography [J]. Breast J, 2010, 16(1): 48.
19. Rao R, Lilley L, Andrews V, et al. Axillary staging by percutaneous biopsy: sensitivity of fineneedle aspiration versus core needle biopsy [J]. Ann Surg Oncol, 2009, 16(5): 11701175.
20. Feng J, Bernacki EG. Intraoperative cytologic evaluation of sentinel lymph nodes in patients with breast carcinoma by scrape preparation [J]. Diagn Cytopathol, 2008, 36(11): 790793.
21. Horvath JW, Barnett GE, Jimenez RE, et al. Comparison of intraoperative frozen section analysis for sentinel lymph node biopsy during breast cancer surgery for invasive lobular carcinoma and invasive ductal carcinoma [J]. World J Surg Oncol, 2009, 7: 34.
22. Krishnamurthy S, MericBernstam F, Lucci A, et al. A prospective study comparing touch imprint cytology, frozen section analysis, and rapid cytokeratin immunostain for intraoperative evaluation of axillary sentinel lymph nodes in breast cancer [J]. Cancer, 2009, 115(7): 15551562.
23. Julian TB, Blumencranz P, Deck K, et al. Novel intraoperative molecular test for sentinel lymph node metastases in patients with earlystage breast cancer [J]. J Clin Oncol, 2008, 26(20): 33383345.
24. Tan LK, Giri D, Hummer AJ, et al. Occult axillary node metastases in breast cancer are prognostically significant: results in 368 nodenegative patients with 20year followup [J]. J Clin Oncol, 2008, 26(11): 18031809.
25. Cox CE, Kiluk JV, Riker AI, et al. Significance of sentinel lymph node micrometastases in human breast cancer [J]. J Am Coll Surg, 2008, 206(2): 261268.
26. de Boer M, van Deurzen CH, van Dijck JA, et al. Micrometastases or isolated tumor cells and the outcome of breast cancer [J]. N Engl J Med, 2009, 361(7): 653663.
27. Veronesi U, Luini A, Galimberti V, et al. Extent of metastatic axillary involvement in 1 446 cases of breast cancer [J]. Eur J Surg Oncol, 1990, 16(2):127133.
28. Xu X, Roberts SA, Pasha TL, et al. Undesirable cytokeratin immunoreactivity of native nonepithelial cells in sentinel lymph nodes from patients with breast carcinoma [J]. Arch Pathol Lab Med, 2000, 124(9): 13101313.
29. Youngson BJ, Liberman L, Rosen PP. Displacement of carcinomatous epithelium in surgical breast specimens following stereotaxic core biopsy [J]. Am J Clin Pathol, 1995, 103(5): 598602.
30. Bleiweiss IJ, Nagi CS, Jaffer S. Axillary sentinel lymph nodes can be falsely positive due to iatrogenic displacement and transport of benign epithelial cells in patients with breast carcinoma [J]. J Clin Oncol, 2006, 24(13): 20132018.
31. National Comprehensive Cancer Network: NCCN clinical practice guidelines in oncology. Breast Cancer. v 2. 2008 [EB/OL]. http://www.nccn.org/professionals/physician_gls/PDF/breast.pdf.
32. Virnig BA, Tuttle TM, Shamliyan T, et al. Ductal carcinoma in situ of the breast: a systematic review of incidence, treatment, and outcomes [J]. J Natl Cancer Inst, 2010, 102(3): 170178.
33. Tada K, Ogiya A, Kimura K, et al. Ductal carcinoma in situ and sentinel lymph node metastasis in breast cancer [J]. World J Surg Oncol, 2010, 8: 6.
34. van la Parra RF, Ernst MF, Barneveld PC, et al. The value of sentinel lymph node biopsy in ductal carcinoma in situ (DCIS) and DCIS with microinvasion of the breast [J]. Eur J Surg Oncol, 2008, 34(6): 631635.
35. Yen TW, Hunt KK, Ross MI, et al. Predictors of invasive breast cancer in patients with an initial diagnosis of ductal carcinoma in situ: a guide to selective use of sentinel lymph node biopsy in management of ductal carcinoma in situ [J]. J Am Coll Surg, 2005, 200(4): 516526.
36. Schrenk P, Hochreiner G, Fridrik M, et al. Sentinel node biopsy performed before preoperative chemotherapy for axillary lymph node staging in breast cancer [J]. Breast J, 2003, 9(4): 282287.
37. Gimbergues P, Abrial C, Durando X, et al. Sentinel lymph node biopsy after neoadjuvant chemotherapy is accurate in breast cancer patients with a clinically negative axillary nodal status at presentation [J]. Ann Surg Oncol, 2008, 15(5): 13161321.
38. Holwitt DM, Gillanders WE, Aft RL, et al. Sentinel lymph node biopsy in patients with multicentric/multifocal breast cancer: low falsenegative rate and lack of axillary recurrence [J]. Am J Surg, 2008, 196(4): 562565.
39. Knauer M, Konstantiniuk P, Haid A, et al. Multicentric breast cancer: a new indication for sentinel node biopsy-a multiinstitutional validation study [J]. J Clin Oncol, 2006, 24(21): 33743380.
40. D’Eredita’ G, Giardina C, Ingravallo G, et al. Sentinel lymph node biopsy in multiple breast cancer using subareolar injection of the tracer [J]. Breast, 2007, 16(3): 316322.
41. Boughey JC, Khakpour N, MericBernstam F, et al. Selective use of sentinel lymph node surgery during prophylactic mastectomy [J]. Cancer, 2006， 107(7): 14401447.
42. Lyman GH, Giuliano AE, Somerfield MR, et al. American Society of Clinical Oncology guideline recommendations for sentinel lymph node biopsy in earlystage breast cancer [J]. J Clin Oncol, 2005, 23(30): 77037720.
43. Rodriguez Fernandez J, Martella S, Trifirò G, et al. Sentinel node biopsy in patients with previous breast aesthetic surgery [J]. Ann Surg Oncol, 2009, 16(4): 989992.
44. Intra M, Trifirò G, Galimberti V, et al. Second axillary sentinel node biopsy for ipsilateral breast tumour recurrence [J]. Br J Surg, 2007, 94(10): 12161219.
45. PanditTaskar N, Dauer LT, Montgomery L, et al. Organ and fetal absorbed dose estimates from 99Tcmsulfur colloid lymphoscintigraphy and sentinel node localization in breast cancer patients [J]. J Nucl Med, 2006, 47(7): 12021208.
46. Yen TW, Fan X, Sparapani R, et al. A contemporary, populationbased study of lymphedema risk factors in older women with breast cancer [J]. Ann Surg Oncol, 2009, 16(4): 979988.
47. Cox CE, Dupont E, Whitehead GF, et al. Age and body mass index may increase the chance of failure in sentinel lymph node biopsy for women with breast cancer [J]. Breast J, 2002, 8(2): 8891.
48. Jinno H, Ikeda T, Asaga S, et al. Increasing age does not affect efficacy of sentinel lymph node biopsy using smallersized technetium99m tin colloids for breast cancer patients [J]. Am J Surg, 2005, 190(1): 5154.
49. Wang J, Kollias J, Marsh C, et al. Are males with early breast cancer treated differently from females with early breast cancer in Australia and New Zealand? [J]. Breast, 2009, 18(6): 378381.
50. Gentilini O, Chagas E, Zurrida S, et al. Sentinel lymph node biopsy in male patients with early breast cancer [J]. Oncologist, 2007, 12(5): 512515.
51. Purushotham AD, Upponi S, Klevesath MB, et al. Morbidity after sentinel lymph node biopsy in primary breast cancer: results from a randomized controlled trial [J]. J Clin Oncol, 2005, 23(19): 43124321.
52. CraneOkada R, Wascher RA, Elashoff D, et al. Longterm morbidity of sentinel node biopsy versus complete axillary dissection for unilateral breast cancer [J]. Ann Surg Oncol, 2008, 15(7): 19962005.
53. 王永胜. 乳腺癌前哨淋巴结活检: 共识与展望 [J]. 中国普外基础与临床杂志, 2009, 16(7): 505509.

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