背景:临床解剖学回顾和初步研究表明,在任何部位进行实质内注射,即使是那些没有索引病变的人,或乳晕周围注射应提供与肿瘤周围注射一致的结果.
方法:这是一个在朱拉隆功王纪念医院进行的单中心回顾性队列研究。患者的电子病历分为常规和新注射概念组。纳入标准是进行了乳房切除术或BCS以及SLNB的患者。我们排除了接受ALND的患者,接受新辅助治疗,或者患有非侵袭性乳腺癌。主要结果是乳腺癌区域复发率的5年。此外,我们报告了再次手术率,无病期,远处无病期,死亡率,局部和全身复发率。通过临床评估和成像确定复发。
方法:注射3毫升1%异硫丹蓝染料,注射部位根据所应用的具体概念而变化。在SSM和NSM遵循新概念的情况下,在非乳晕周围和非瘤周部位注射蓝色染料.注射后,在没有按摩注射部位的情况下观察到10分钟的间隔。在此间隔之后,做了一个切口来进入SLN,随后被确认,切除,并送去进行冰冻切片分析或永久性切片检查。
结果:DFS没有显著差异,两组间的DDFS或BCSS(p=0.832、0.712、0.157)。尽管NI组的再手术率大约是CI组的一半,这一差异无统计学意义(p=0.355).
结论:我们的研究表明,根据手术类型而不是肿瘤位置定制异硫丹蓝染料注射部位是早期乳腺癌SLN定位的安全有效方法。然而,这项研究有局限性,包括低复发和死亡病例的单中心研究。未来的研究应旨在增加样本量和随访期。
BACKGROUND: Clinico-anatomical review and pilot studies demonstrated that intraparenchymal injection at any site, even those not containing the index lesion, or periareolar injections should provide concordant outcomes to peritumoral injections.
METHODS: This was a single-center retrospective cohort at King Chulalongkorn Memorial Hospital. The electronic medical records of patients were characterized into conventional and new injection concept groups. The inclusion criteria were patients who had either a mastectomy or BCS along with SLNB. We excluded patients who underwent ALND, received neoadjuvant therapy, or had non-invasive breast cancer. The primary outcome was the 5-year rate of breast cancer regional recurrence. Additionally, we reported on the re-operation rate, disease-free period, distant disease-free period, mortality rate, and recurrence rates both locoregional and systemic. Recurrences were identified through clinical assessments and imaging.
METHODS: 3 ml of 1%isosulfan blue dye was injected, with the injection site varying according to the specific concept being applied. In cases of SSM and NSM following the new concept, the blue dye was injected at non-periareolar and non-peritumoral sites. After the injection, a 10-minute interval was observed without massaging the injection site. Following this interval, an incision was made to access the SLNs, which were subsequently identified, excised, and sent for either frozen section analysis or permanent section examination.
RESULTS: There were no significant differences in DFS, DDFS or BCSS between the two groups (p = 0.832, 0.712, 0.157). Although the re-operation rate in the NI group was approximately half that of the CI group, this difference was not statistically significant (p = 0.355).
CONCLUSIONS: Our study suggests that tailoring isosulfan blue dye injection site based on operation type rather than tumor location is safe and effective approach for SLN localization in early-stage breast cancer. However, this study has limitations, including being a single-center study with low recurrence and death cases. Future studies should aim to increase the sample size and follow-up period.