지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.97 No.2
- 발행연도
- 2019.8
- 수록면
- 49 - 57 (9page)
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초록· 키워드
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Purpose: Sentinel lymph node (SLN) biopsy (SLNB) is widely performed for axillary staging in patients with breast cancer. Based on the results of frozen section examination (FSE), surgeons can decide to continue further axillary dissections. This study aimed to verify the accuracy of FSE for SLNs.
Methods: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model.
Results: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7%) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8%). The overall accuracy of SLNB was 98.5%. The sensitivity and false-negative rate of FSE were 86.4% and 13.6%, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results.
Conclusion: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.
Methods: We reviewed the records of 4,219 patients who underwent SLNB for primary invasive breast cancer between 2007 and 2016 at the Severance Hospital. We evaluated factors associated with the false-negative results of FSE for SLNs using the Generalized Estimating Equations model.
Results: A total of 1,397 SLNs from 908 patients were confirmed to be metastatic. Seventy-one patients (1.7%) had confirmed pathologic N2 or N3 stage. Among metastatic SLNs, micrometastasis was found in 234 (16.8%). The overall accuracy of SLNB was 98.5%. The sensitivity and false-negative rate of FSE were 86.4% and 13.6%, respectively. Several clinicopathological factors, including the size of SLN metastases, suspicious preoperative axillary lymph nodes, and luminal B subtype, were associated with a higher rate of false-negative results.
Conclusion: Most patients were not indicated for axillary lymph node dissection. Some patients may show transition in their permanent pathology due to the size of the metastatic node. However, the false-negative results of FSE for SLNs based on the size of the metastatic node did not change our practice. Therefore, intraoperative FSE for SLN should not be routinely performed for all breast cancer patients.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (26)
참고문헌 신청
Canavese G / 2009 / Sentinel node biopsy compared with complete axillary dissection for staging early breast cancer with clinically negative lymph nodes : results of randomized trial / Ann Oncol 20:1001~1007
Mansel RE / 2006 / Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer : the ALMANAC Trial / J Natl Cancer Inst 98:599~609
Veronesi U / 2003 / A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer / N Engl J Med 349:546~553
Zavagno G / 2008 / A randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer : results of the Sentinella/GIVOM trial / Ann Surg 247:207~213
Galimberti V / 2018 / Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases(IBCSG 23-01) : 10-year follow-up of a randomised, controlled phase 3 trial / Lancet Oncol 19:1385~1393
Mansel RE / 2006 / Randomized multicenter trial of sentinel node biopsy versus standard axillary treatment in operable breast cancer : the ALMANAC Trial / J Natl Cancer Inst 98:599~609
Veronesi U / 2003 / A randomized comparison of sentinel-node biopsy with routine axillary dissection in breast cancer / N Engl J Med 349:546~553
Zavagno G / 2008 / A randomized clinical trial on sentinel lymph node biopsy versus axillary lymph node dissection in breast cancer : results of the Sentinella/GIVOM trial / Ann Surg 247:207~213
Galimberti V / 2018 / Axillary dissection versus no axillary dissection in patients with breast cancer and sentinel-node micrometastases(IBCSG 23-01) : 10-year follow-up of a randomised, controlled phase 3 trial / Lancet Oncol 19:1385~1393
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UCI(KEPA) : I410-ECN-0101-2019-514-000942541