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前哨淋巴结活检与腋窝淋巴结清扫术在早期乳腺癌患者治疗中的研究进展
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Abstract:
乳腺癌的诊疗过程中，腋窝淋巴结的状态对肿瘤分期、治疗选择以及预后评估至关重要。前哨淋巴结活检(SLNB)作为一种微创诊断技术，已成为腋窝淋巴结阴性患者的常规治疗方案，尤其适用于早期乳腺癌患者。尽管SLNB具有创伤小、并发症少等优势，但针对前哨淋巴结阳性患者，腋窝淋巴结清扫术(ALND)仍被视为标准治疗方法。近年来的研究表明，对于1~2个淋巴结微转移的患者，可能不需要进行ALND，这对患者的生存率影响较小。然而，早期乳腺癌患者的腋窝淋巴结处理仍存在广泛的学术争议。本文旨在通过系统分析前哨淋巴结活检与腋窝淋巴结清扫术的相关文献，探讨不同治疗方式对早期乳腺癌患者预后的影响，并提出个性化、精准化治疗的可能性。
In the diagnosis and treatment of breast cancer, the status of axillary lymph nodes plays a critical role in tumor staging, treatment selection, and prognosis assessment. Sentinel lymph node biopsy (SLNB), a minimally invasive diagnostic technique, has become the standard procedure for axillary lymph node-negative patients, especially in early-stage breast cancer. While SLNB offers the advantages of minimal trauma and fewer complications, axillary lymph node dissection (ALND) is still regarded as the standard treatment for patients with positive sentinel lymph nodes. Recent studies suggest that for patients with micro-metastasis in 1 to 2 lymph nodes, ALND may not be necessary, as its impact on overall survival is minimal. However, there is still significant academic debate regarding the management of axillary lymph nodes in early-stage breast cancer patients. This article aims to systematically analyze the literature on SLNB and ALND, exploring their impact on prognosis in early-stage breast cancer patients and discussing the potential for personalized and precise treatment approaches.
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