| Citation: |
WANG Yu, KANG Hua. Assessment and Management of Axillary Lymph Nodes for Breast Cancer Under Concept of Precision Therapy[J]. Cancer Research on Prevention and Treatment, 2022, 49(10): 1003-1009. DOI: 10.3971/j.issn.1000-8578.2022.22.0351
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The status of axillary lymph nodes is important for the staging, treatment, and prognosis of breast cancer. The arrival of the era of precision medicine highlights the importance of axillary lymph nodes status assessment. Magnetic resonance imaging, positron emission tomography/computed tomography, and new imaging examinations can be used in the assessment of axillary lymph nodes, in addition to routine examinations, such as physical examination and breast ultrasound. Sentinel lymph node biopsy is the most significant method for the assessment of axillary lymph nodes. Emerging evidence suggests that axillary lymph node dissection can be avoided in patients with negative or 1–2 positive sentinel lymph nodes. The ratio of inflammatory indicators may be a reliable predictor of lymph node metastases. Specific elder patients can have a good prognosis without axillary procedure. In this paper, we review and summarize the controversies surrounding the assessment methods and management of axillary lymph nodes. We hope to provide new perspectives for the axillary lymph node diagnosis and management of breast cancer patients under the concept of precision therapy.
Competing interests: The authors declare that they have no competing interests.
| [1] |
Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. doi: 10.3322/caac.21660
|
| [2] |
Feng RM, Zong YN, Cao M, et al. Current cancer situation in China: good or bad news from the 2018 Global Cancer Statistics?[J]. Cancer Commun(Lond), 2019, 39(1): 22.
|
| [3] |
张雪, 董晓平, 管雅喆, 等. 女性乳腺癌流行病学趋势及危险因素研究进展[J]. 肿瘤防治研究, 2021, 48(1): 87-92. doi: 10.3971/j.issn.1000-8578.2021.20.0498
Zhang X, Dong XP, Guan YZ, et al. Research Progress on Epidemiological Trend and Risk Factors of Female Breast Cancer[J]. Zhong Liu Fang Zhi Yan Jiu, 2021, 48(1): 87-92. doi: 10.3971/j.issn.1000-8578.2021.20.0498
|
| [4] |
Rao R, Euhus D, Mayo HG, et al. Axillary Node Interventions in Breast Cancer: A Systematic Review[J]. JAMA, 2013, 310(13): 1385-1394. doi: 10.1001/jama.2013.277804
|
| [5] |
Gipponi M, Fregatti P, Garlaschi A, et al. Axillary ultrasound and Fine-Needle Aspiration Cytology in the preoperative staging of axillary node metastasis in breast cancer patients[J]. Breast, 2016, 30: 146-150. doi: 10.1016/j.breast.2016.09.009
|
| [6] |
Cox K, Taylor-Phillips S, Sharma N, et al. Enhanced pre-operative axillary staging using intradermal microbubbles and contrast-enhanced ultrasound to detect and biopsy sentinel lymph nodes in breast cancer: a potential replacement for axillary surgery[J]. Br J Radiol, 2018, 91(1082): 20170626.
|
| [7] |
Murray AD, Staff RT, Redpath TW, et al. Dynamic contrast enhanced MRI of the axilla in women with breast cancer: comparison with pathology of excised nodes[J]. Br J Radiol, 2002, 75(891): 220-228. doi: 10.1259/bjr.75.891.750220
|
| [8] |
Douek M, Klaase J, Monypenny I, et al. Sentinel Node Biopsy Using a Magnetic Tracer Versus Standard Technique: The SentiMAG Multicentre Trial[J]. Ann Surg Oncol, 2014, 21(4): 1237-1245. doi: 10.1245/s10434-013-3379-6
|
| [9] |
Koolen BB, Valdés Olmos RA, Elkhuizen PHM, et al. Locoregional lymph node involvement on 18F-FDG PET/CT in breast cancer patients scheduled for neoadjuvant chemotherapy[J]. Breast Cancer Res Treat, 2012, 135(1): 231-240. doi: 10.1007/s10549-012-2179-1
|
| [10] |
Botsikas D, Kalovidouri A, Becker M, et al. Clinical utility of 18F-FDG-PET/MR for preoperative breast cancer staging[J]. Eur Radiol, 2016, 26(7): 2297-2307. doi: 10.1007/s00330-015-4054-z
|
| [11] |
Szyc L, Bonifer S, Walter A, et al. Development of a handheld fluorescence imaging camera for intraoperative sentinel lymph node mapping[J]. J Biomed Opt, 2015, 20(5): 051025. doi: 10.1117/1.JBO.20.5.051025
|
| [12] |
Krag DN, Weaver DL, Alex JC, et al. Surgical resection and radiolocalization of the sentinel lymph node in breast cancer using a gamma probe[J]. Surg Oncol, 1993, 2(6): 335-339, discussion 340.
|
| [13] |
Albertini JJ, Lyman GH, Cox C, et al. Lymphatic mapping and sentinel node biopsy in the patient with breast cancer[J]. JAMA, 1996, 276(22): 1818-1822. doi: 10.1001/jama.1996.03540220042028
|
| [14] |
中国抗癌协会乳腺癌专业委员会. 中国抗癌协会乳腺癌诊治指南与规范(2021年版)[J]. 中国癌症杂志, 2021, 31(10): 954-1040. doi: 10.19401/j.cnki.1007-3639.2021.10.013
Chinese Anti-Cancer Association, Committee of Breast Cancer Society. Chinese Anti-Cancer Association Guideline for Breast Cancer (2021)[J]. Zhongguo Ai Zheng Za Zhi, 2021, 31(10): 954-1040. doi: 10.19401/j.cnki.1007-3639.2021.10.013
|
| [15] |
Motomura K, Inaji H, Komoike Y, et al. Sentinel Node Biopsy Guided by Indocyanin Green Dye in Breast Cancer Patients[J]. Jap J Clin Oncol, 1999, 29(12): 604-607. doi: 10.1093/jjco/29.12.604
|
| [16] |
Kitai T, Inomoto T, Miwa M, et al. Fluorescence navigation with indocyanine green for detecting sentinel lymph nodes in breast cancer[J]. Breast Cancer, 2005, 12(3): 211-215. doi: 10.2325/jbcs.12.211
|
| [17] |
Ahmed M, Purushotham AD, Douek M. Novel techniques for sentinel lymph node biopsy in breast cancer: a systematic review[J]. Lancet Oncol, 2014, 15(8): e351-e362. doi: 10.1016/S1470-2045(13)70590-4
|
| [18] |
侯丁丁, 康骅. 近红外荧光在乳腺癌前哨淋巴结活检中的应用现状[J]. 临床外科杂志, 2016, 24(9): 719-721. doi: 10.3969/j.issn.1005-6483.2016.09.027
Hou DD, Kang H. The application of near-infrared fluorescent method in sentinel lymph node biopsy of breast cancer[J]. Lin Chuang Wai Ke Za Zhi, 2016, 24(9): 719-721. doi: 10.3969/j.issn.1005-6483.2016.09.027
|
| [19] |
Takemoto N, Koyanagi A, Yasuda M, et al. Comparison of the indocyanine green dye method versus the combined method of indigo carmine blue dye with indocyanine green fluorescence imaging for sentinel lymph node biopsy in breast conservative therapy for stage≤ⅡA breast cancer[J]. BMC Womens Health, 2018, 18(1): 151. doi: 10.1186/s12905-018-0646-5
|
| [20] |
Yang C, Lan H, Gao F, et al. Review of deep learning for photoacoustic imaging[J]. Photoacoustics, 2020, 21: 100215.
|
| [21] |
Upputuri PK, Pramanik M. Recent advances in photoacoustic contrast agents for in vivo imaging[J]. Wiley Interdiscip Rev Nanomed Nanobiotechnol, 2020, 12(4): e1618.
|
| [22] |
赵家贤, 江道淮, 丛斌斌, 等. 新型光声传感及成像系统探测乳腺癌前哨淋巴结的基础研究[J]. 中国癌症杂志, 2022, 32(2): 106-117. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202202002.htm
Zhao JX, Jiang DH, Cong BB, et al. Basic research on photoacoustic sensing and imaging system for detecting sentinel lymph node in breast cancer[J]. Zhongguo Ai Zheng Za Zhi, 2022, 32(2): 106-117. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGAZ202202002.htm
|
| [23] |
康骅, 李开富. 乳腺癌前哨淋巴结活检的现状及值得注意的问题[J]. 中国医刊, 2011, 46(2): 3-6. doi: 10.3969/j.issn.1008-1070.2011.02.001
Kang H, Li KF. Current status and noteworthy concern of biopsy of sentinel lymph nodes in breast cancer[J]. Zhongguo Yi Kan, 2011, 46(2): 3-6. doi: 10.3969/j.issn.1008-1070.2011.02.001
|
| [24] |
Ban EJ, Lee JS, Koo JS, et al. How Many Sentinel Lymph Nodes Are Enough for Accurate Axillary Staging in T1-2 Breast Cancer?[J]. J Breast Cancer, 2011, 14(4): 296-300. doi: 10.4048/jbc.2011.14.4.296
|
| [25] |
Yi M, Meric-Bernstam F, Ross MI, et al. How Many Sentinel Lymph Nodes Are Enough During Sentinel Lymph Node Dissection for Breast Cancer?[J]. Cancer, 2008, 113(1): 30-37. doi: 10.1002/cncr.23514
|
| [26] |
Krag DN, Anderson SJ, Julian TB, et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial[J]. Lancet Oncol, 2010, 11(10): 927-933. doi: 10.1016/S1470-2045(10)70207-2
|
| [27] |
Galimberti V, Cole BF, Zurrida S, et al. Axillary dissection versus no axillary dissection in patients with sentinel-node micrometastases (IBCSG 23-01): a phase 3 randomised controlled trial[J]. Lancet Oncol, 2013, 14(4): 297-305. doi: 10.1016/S1470-2045(13)70035-4
|
| [28] |
Galimberti V, Cole BF, Viale G, et al. 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[J]. Lancet Oncol, 2018, 19(10): 1385-1393. doi: 10.1016/S1470-2045(18)30380-2
|
| [29] |
Kim T, Giuliano AE, Lyman GH. Lymphatic mapping and sentinel lymph node biopsy in early-stage breast carcinoma: a meta analysis[J]. Cancer, 2006, 106(1): 4-16. doi: 10.1002/cncr.21568
|
| [30] |
Giuliano AE, Hunt KK, Ballman KV, et al. Axillary Dissection vs No Axillary Dissection in Women With Invasive Breast Cancer and Sentinel Node Metastasis: A Randomized Clinical Trial[J]. JAMA, 2011, 305(6): 569-575. doi: 10.1001/jama.2011.90
|
| [31] |
Giuliano AE, Ballman KV, McCall L, et al. Effect of Axillary Dissection vs No Axillary Dissection on 10-Year Overall Survival Among Women With Invasive Breast Cancer and Sentinel Node Metastasis: The ACOSOG Z0011 (Alliance) Randomized Clinical Trial[J]. JAMA, 2017, 318(10): 918-926. doi: 10.1001/jama.2017.11470
|
| [32] |
Kuehn T, Bauerfeind I, Fehm T, et al. Sentinel-lymph-node biopsy in patients with breast cancer before and after neoadjuvant chemotherapy (SENTINA): a prospective, multicentre cohort study[J]. Lancet Oncol, 2013, 14(7): 609-618. doi: 10.1016/S1470-2045(13)70166-9
|
| [33] |
Boughey JC, Suman VJ, Mittendorf EA, et al. Sentinel Lymph Node Surgery after Neoadjuvant Chemotherapy in Patients With Node-Positive Breast Cancer: The American College of Surgeons Oncology Group (ACOSOG) Z1071 Clinical Trial[J]. JAMA, 2013, 310(14): 1455-1461. doi: 10.1001/jama.2013.278932
|
| [34] |
Boughey JC, Ballman KV, Le-Petross HT, et al. Identification and Resection of Clipped Node Decreases the False-negative Rate of Sentinel Lymph Node Surgery in Patients Presenting With Node-positive Breast Cancer (T0-T4, N1-N2) Who Receive Neoadjuvant Chemotherapy: Results From ACOSOG Z1071 (Alliance)[J]. Ann Surg, 2016, 263(4): 802-807. doi: 10.1097/SLA.0000000000001375
|
| [35] |
Boileau JF, Poirier B, Basik M, et al. Sentinel Node Biopsy After Neoadjuvant Chemotherapy in Biopsy-Proven Node-Positive Breast Cancer: The SN FNAC Study[J]. J Clin Oncol, 2015, 33(3): 258-264. doi: 10.1200/JCO.2014.55.7827
|
| [36] |
Donker M, van Tienhoven G, Straver ME, et al. Radiotherapy or surgery of the axilla after a positive sentinel node in breast cancer (EORTC 10981-22023 AMAROS): a randomised, multicentre, open-label, phase 3 non-inferiority trial[J]. Lancet Oncol, 2014, 15(12): 1303-1310. doi: 10.1016/S1470-2045(14)70460-7
|
| [37] |
Van Zee KJ, Manasseh DM, Bevilacqua JL, et al. A Nomogram for Predicting the Likelihood of Additional Nodal Metastases in Breast Cancer Patients With a Positive Sentinel Node Biopsy[J]. Ann Surg Oncol, 2003, 10(10): 1140-1151. doi: 10.1245/ASO.2003.03.015
|
| [38] |
邢君, 马利军, 闫峥峥, 等. 乳腺癌非前哨淋巴结转移的危险因素研究[J]. 中华实验外科杂志, 2021, 38(3): 529-533. doi: 10.3760/cma.j.cn421213-20200801-01279
Xing J, Ma LJ, Yan ZZ, et al. Risk factors of non-sentinel lymph node metastasis in breast cancer patients[J]. Zhonghua Shi Yan Wai Ke Za Zhi, 2021, 38(3): 529-533. doi: 10.3760/cma.j.cn421213-20200801-01279
|
| [39] |
Gur AS, Unal B, Ozbek U, et al. Validation of breast cancer nomograms for predicting the non-sentinel lymph node metastases after a positive sentinel lymph node biopsy in a multi-center study[J]. Eur J Surg Oncol, 2010, 36(1): 30-35. doi: 10.1016/j.ejso.2009.05.007
|
| [40] |
Chen J, Chen J, Yang B, et al. Predicting sentinel lymph node metastasis in a Chinese breast cancer population: assessment of an existing nomogram and a new predictive nomogram[J]. Breast Cancer Res Treat, 2012, 135(3): 839-848. doi: 10.1007/s10549-012-2219-x
|
| [41] |
Qiao E, Yu X, Zhou L, et al. A Prospective Validation Cohort Study of a Prediction Model on Non-sentinel Lymph Node Involvement in Early Breast Cancer[J]. Ann Surg Oncol, 2020, 27(5): 1653-1658. doi: 10.1245/s10434-019-07980-x
|
| [42] |
Cho J, Han W, Lee JW, et al. A Scoring System to Predict Nonsentinel Lymph Node Status in Breast Cancer Patients with Metastatic Sentinel Lymph Nodes: A Comparison with Other Scoring Systems[J]. Ann Surg Oncol, 2008, 15(8): 2278-2286. doi: 10.1245/s10434-008-9993-z
|
| [43] |
Chen L, Kong X, Yan C, et al. The Research Progress on the Prognostic Value of the Common Hematological Parameters in Peripheral Venous Blood in Breast Cancer[J]. Onco Targets Ther, 2020, 13: 1397-1412. doi: 10.2147/OTT.S227171
|
| [44] |
Yang L, Wang H, Ma J, et al. Association between the platelet to lymphocyte ratio, neutrophil to lymphocyte ratio and axillary lymph node metastasis in cT1N0 breast cancer patients[J]. Am J Transl Res, 2021, 13(3): 1854-1861.
|
| [45] |
Huang O, Wang L, Shen K, et al. Breast cancer subpopulation with high risk of internal mammary lymph nodes metastasis: analysis of 2, 269 Chinese breast cancer patients treated with extended radical mastectomy[J]. Breast Cancer Res Treat, 2008, 107(3): 379-387. doi: 10.1007/s10549-007-9561-4
|
| [46] |
Qi X, Du J, Tang P, et al. Clinical significance of internal mammary lymph node metastasis for breast cancer: Analysis of 337 breast cancer patients[J]. Surg Oncol, 2018, 27(2): 185-191. doi: 10.1016/j.suronc.2018.03.006
|
| [47] |
Martelli G, Miceli R, Daidone MG, et al. Axillary Dissection Versus No Axillary Dissection in Elderly Patients with Breast Cancer and No Palpable Axillary Nodes: Results After 15 Years of Follow-Up[J]. Ann Surg Oncol, Springer, 2011, 18(1): 125-133. doi: 10.1245/s10434-010-1217-7
|
| [48] |
Gentilini O, Botteri E, Dadda P, et al. Physical function of the upper limb after breast cancer surgery. Results from the SOUND (Sentinel node vs. Observation after axillary Ultra-souND) trial[J]. Eur J Surg Oncol, 2016, 42(5): 685-689. doi: 10.1016/j.ejso.2016.01.020
|
| [49] |
Gentilini O, Veronesi U. Abandoning sentinel lymph node biopsy in early breast cancer? A new trial in progress at the European Institute of Oncology of Milan (SOUND: entinel node vs. bservation after axillary ltraSou)[J]. Breast, 2012, 21(5): 678-681. doi: 10.1016/j.breast.2012.06.013
|
| [50] |
Reimer T, Stachs A, Nekljudova V, et al. Restricted Axillary Staging in Clinically and Sonographically Node-Negative Early Invasive Breast Cancer (c/iT1-2) in the Context of Breast Conserving Therapy: First Results Following Commencement of the Intergroup-Sentinel-Mamma(INSEMA) Trial[J]. Geburtshilfe Frauenheilkd, 2017, 77(2): 149-157. doi: 10.1055/s-0042-122853
|
| [51] |
van Roozendaal LM, Vane MLG, van Dalen T, et al. Clinically node negative breast cancer patients undergoing breast conserving therapy, sentinel lymph node procedure versus follow-up: a Dutch randomized controlled multicentre trial (BOOG 2013-08)[J]. BMC Cancer, 2017, 17(1): 459. doi: 10.1186/s12885-017-3443-x
|
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