Endoscopic Sentinel Lymph Node Biopsy in Breast Cancer：Clinical Application and Effect Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Yi , YANG Xinhua , FAN Linjun , TANG Peng , WANG Shushu , JIANG Jun

Breast Disease Center， Southwest Hospital， Third Military Medical University， Chongqing 400038， China;

Corresponding author：

Keywords：

Breast cancer; Sentinel lymph node; Biopsy; Endoscopic surgery

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Objective 　To investigate the feasibility and operation effect of endoscopic sentinel lymph node biopsy （SLNB） in breast cancer.
Methods 　The data of 410 breast cancer patients who underwent SLNB （including 107 patients with endoscopy and 303 with open operation） were analyzed in our hospital from January 2009 to March 2012. SLNB was performed by using methylene blue staining or the combination of methylene blue and 99Tcm-sulfur colloid tracing.
Results 　The successful rate of SLN detection with methylene blue and 99Tcm-sulfur colloid tracing was 94.56% （139/147） in open operation group and 94.25% （82/87） in endoscopy group. The successful rate of SLN detection with methylene blue was 88.46% （138/156）in open operation group and 85.00% （17/20） in endoscopy group. The mean of detected SLN number with combined method or methylene blue was 1.90/1.98 in open operation group and 1.91/1.82 in endoscopy group respectively. SLN-positive rate was 22.30% （31/139） and 25.36% （35/138） in open operation group， and 19.51% （16/82） and 23.53% （4/17） in endoscopy group， respectively. The rate of subcutaneous effusion in endoscopy group was higher than that in open operation group （P=0.001）, but other postoperative complications presented no significant difference.
Conclusions 　Endoscopic SLNB can obtain the similar safety and the clinical efficacy with traditional SLNB， but superior cosmetic effect. So it is worthy of clinical application in breast cancer.

Citation： ZHANG Yi,YANG Xinhua,FAN Linjun,TANG Peng,WANG Shushu,JIANG Jun,.. Endoscopic Sentinel Lymph Node Biopsy in Breast Cancer：Clinical Application and Effect Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(9): 930-933. doi: Copy

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8.	张毅，杨新华，周艳，等. 临床Ⅰ期和Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术效果及预后分析[J]. 中华乳腺病杂志(电子版)，2010， 4(1)：27-29.
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13.	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)：505-507.
14.	Veronesi U， Paganelli G， Viale G， et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer[J]. N Engl J Med， 2003， 349(6)：546-553.
15.	Julian TB， Krag D， Brown A， et al. Preliminary technical results of NSABP B-32， a randomized phase Ⅲ clinical trial to compare sentinel node resection to conventional axillary dissection in clinically node-negative breast cancer patients[J]. Breast Cancer Res Treat， 2004， 88(Suppl 1)：S11-S12.
16.	Colfry AJ， Zhang X， Fuhrman GM. Response to neoadjuvant chemotherapy in the breast predicts axillary nodal status[J]. Am Surg， 2012， 78(6)：693-697.
17.	Harwood R， Douglas C， Clark D. Decision aids for breast and nodal surgery in patients with early breast cancer：development and a pilot study[J]. Asia Pac J Clin Oncol， 2011， 7(2)：114-122.
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19.	丁波泥，李小荣，陈道瑾，等. 乳腺癌乳腔镜腋窝淋巴结清扫术与常规手术的比较[J]. 中国微创外科杂志， 2010， 10(12)：1063-1065.
20.	骆成玉. 乳腺癌乳腔镜腋窝淋巴结清扫手术的临床实践与思考[J]. 中华腔镜外科杂志(电子版)， 2010， 3(1)：47-56.
21.	郭美琴，姜军，杨新华，等. 吸脂法腔镜腋窝淋巴结清扫手术的技术探讨[J]. 中华外科杂志， 2006， 44(11)：757-761.
22.	姜军. 乳腺癌腔镜腋窝淋巴结清扫术的争论与实践[J]. 中华普通外科学文献， 2009， 3(6)：456-457.
23.	郭美琴，姜军，杨新华，等. 吸脂法腔镜腋窝淋巴结清除术野脱落细胞学研究[J]. 中华肿瘤防治杂志， 2009， 16(9)：710-712.
24.	Langer T， Kocher U， Guller J， et al. Long-term outcomes of breast cancer patients after endoscopic axillary lymph node dissection：a prospective analysis of 52 patients[J]. Breast Cancer Res Treat， 2005， 90(1)：85-91.
25.	梁阔，康骅，海涛，等. 乳腺癌腔镜前哨淋巴结活检83例临床分析[J]. 中国微创外科杂志， 2010， 10(5)：420-422.

1. Kothari MS， Rusby JE， Agusti AA， et al. Sentinel lymph node biopsy after previous axillary surgery：A review[J]. Eur J Surg Oncol， 2012， 38(1)：8-15.
2. Tan VK， Goh BK， Fook-Chong S， et al. The feasibility andaccuracy of sentinel lymph node biopsy in clinically node-negativepatients after neoadjuvant chemotherapy for breast cancer—a systematic review and meta-analysis[J]. J Surg Oncol， 2011， 104(1)：97-103.
3. Petronella P， Scorzelli M， Benevento R， et al. The sentinel lymph node：a suitable technique in breast cancer treatment?[J]. Ann Ital Chir， 2012， 83(2)：119-123.
4. 陈翔，王水. 乳腺癌前哨淋巴结活检研究现状及进展[J]. 中国普外基础与临床杂志， 2011， 18(1)：98-100.
5. Fan LJ， Jiang J， Yang XH， et al. A prospective study comparing endoscopic subcutaneous mastectomy plus immediate reconstruction with implants and breast conserving surgery for breastcancer[J]. Chin Med J (Engl)， 2009， 122(24)：2945-2950.
6. Leff DR， Vashisht R， Yongue G， et al. Endoscopic breast surgery：where are we now and what might the future hold for video-assisted breast surgery?[J]. Breast Cancer Res Treat， 2011， 125(3)：607-625.
7. 姜军. 腔镜技术在乳腺疾病治疗中的地位及其评价[J]. 中国实用外科杂志， 2010， 30(3)：195-197.
8. 张毅，杨新华，周艳，等. 临床Ⅰ期和Ⅱ期乳腺癌腔镜腋窝淋巴结清扫术效果及预后分析[J]. 中华乳腺病杂志(电子版)，2010， 4(1)：27-29.
9. Carlson RW， Allred DC， Anderson BO， et al. Breast cancer. Clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw， 2009， 7(2)：122-192.
10. 徐冰河. 2009年《NCCN乳腺癌临床实践指南》(中国版)重点内容解读[J]. 中华乳腺病杂志(电子版)， 2009， 3(3)：375-380.
11. 王涛，江泽飞. 乳腺癌辅助治疗若干问题的思考和讨论——2008年《NCCN乳腺癌临床实践指南中国版》解读[J]. 临床肿瘤学杂志， 2008， 13(9)：846-848.
12. Goyal A， Mansel RE. Recent advances in sentinel lymph node biopsy for breast cancer[J]. Curr Opin Oncol， 2008， 20(6)：621-626.
13. 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)：505-507.
14. Veronesi U， Paganelli G， Viale G， et al. A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer[J]. N Engl J Med， 2003， 349(6)：546-553.
15. Julian TB， Krag D， Brown A， et al. Preliminary technical results of NSABP B-32， a randomized phase Ⅲ clinical trial to compare sentinel node resection to conventional axillary dissection in clinically node-negative breast cancer patients[J]. Breast Cancer Res Treat， 2004， 88(Suppl 1)：S11-S12.
16. Colfry AJ， Zhang X， Fuhrman GM. Response to neoadjuvant chemotherapy in the breast predicts axillary nodal status[J]. Am Surg， 2012， 78(6)：693-697.
17. Harwood R， Douglas C， Clark D. Decision aids for breast and nodal surgery in patients with early breast cancer：development and a pilot study[J]. Asia Pac J Clin Oncol， 2011， 7(2)：114-122.
18. Kootstra JJ， Hoekstra-Weebers JE， Rietman JS， et al. A longitudinal comparison of arm morbidity in stageⅠ-Ⅱbreast cancer patients treated with sentinel lymph node biopsy， sentinel lymph node biopsy followed by completion lymph node dissection， or axillary lymph node dissection[J]. Ann Surg Oncol， 2010， 17(9)：2384-2394.
19. 丁波泥，李小荣，陈道瑾，等. 乳腺癌乳腔镜腋窝淋巴结清扫术与常规手术的比较[J]. 中国微创外科杂志， 2010， 10(12)：1063-1065.
20. 骆成玉. 乳腺癌乳腔镜腋窝淋巴结清扫手术的临床实践与思考[J]. 中华腔镜外科杂志(电子版)， 2010， 3(1)：47-56.
21. 郭美琴，姜军，杨新华，等. 吸脂法腔镜腋窝淋巴结清扫手术的技术探讨[J]. 中华外科杂志， 2006， 44(11)：757-761.
22. 姜军. 乳腺癌腔镜腋窝淋巴结清扫术的争论与实践[J]. 中华普通外科学文献， 2009， 3(6)：456-457.
23. 郭美琴，姜军，杨新华，等. 吸脂法腔镜腋窝淋巴结清除术野脱落细胞学研究[J]. 中华肿瘤防治杂志， 2009， 16(9)：710-712.
24. Langer T， Kocher U， Guller J， et al. Long-term outcomes of breast cancer patients after endoscopic axillary lymph node dissection：a prospective analysis of 52 patients[J]. Breast Cancer Res Treat， 2005， 90(1)：85-91.
25. 梁阔，康骅，海涛，等. 乳腺癌腔镜前哨淋巴结活检83例临床分析[J]. 中国微创外科杂志， 2010， 10(5)：420-422.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Endoscopic Sentinel Lymph Node Biopsy in Breast Cancer：Clinical Application and Effect Analysis

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