PDF(Pubmed)
Abstract：
Sentinel lymph node biopsy (SLNB) is currently used as a routine treatment for patients with breast cancer. However, it may not be applicable for patients with male breast cancer (MBC), because they have notably different clinicopathological features from those occurring in females. There is a lack of evidence of SLNB application and safe exemption from axillary lymph node dissection (ALND) in patients with MBC. This study aimed to evaluate the application of SLNB to provide information for the standardized treatment of patients with MBC. The MBC patient records from 4 institutions ranging from January 2001 to November 2020 were retrospectively reviewed. There were 220 patients with MBC with a median age of 60 (range 24-88) years and an average tumor size of 2.3 cm (range 0.5 cm-6.5 cm). Sixty-six percent of patients underwent SLNB, and 39% of them showed positive results. A total of 157 patients underwent ALND, while only half of them had positive nodes, causing unnecessary complications. For patients in the clinical early stage, we found that the SLNB showed a noninferiority to the ALND treatment in DFS (P = .18) and OS (P = .055). In conclusion, there are certain obstacles to the broad application of SLNB due to the lower proportion of patients with clinically negative lymph nodes. However, it is undeniable that SLNB can safely and effectively exempt patients with MBC at early stage with clinically negative nodes from ALND to reduce subsequent complications. It is still an ideal criterion for the axillary staging of patients with MBC.
摘要：
前哨淋巴结活检（SLNB）目前被用作乳腺癌患者的常规治疗方法。然而,它可能不适用于男性乳腺癌（MBC）患者，因为它们的临床病理特征与女性明显不同。MBC患者缺乏SLNB应用和腋窝淋巴结清扫术（ALND）安全豁免的证据。本研究旨在评价SLNB的应用,为MBC患者的规范化治疗提供信息。回顾性审查了2001年1月至2020年11月4个机构的MBC患者记录。有220例MBC患者，中位年龄为60岁（24-88岁），平均肿瘤大小为2.3cm（0.5cm-6.5cm）。66％的患者接受了SLNB，其中39%显示出积极的结果。共有157名患者接受了ALND，虽然其中只有一半有阳性节点，造成不必要的并发症。对于处于临床早期阶段的患者,我们发现SLNB在DFS(P=.18)和OS(P=.055)方面对ALND治疗表现出非劣效性。总之,由于临床淋巴结阴性的患者比例较低，SLNB的广泛应用存在一定的障碍。然而,不可否认,SLNB可以安全有效地免除早期MBC患者的ALND,减少随后的并发症.它仍然是MBC患者腋窝分期的理想标准。
