유방암 환자의 감시림프절 생검술에서 발견되는 고립종양세포의 의미 (Implications of Isolated Tumor Cells in Sentinel Lymph Nodes of Breast Cancer Patients)

서지정보

· 발행기관 : 대한외과학회
· 수록지 정보 : Annals of Surgical Treatment and Research / 77권 / 6호 / 378 ~ 384페이지
· 저자명 : 김균지, 최재혁, 김완욱, 이세경, 임혜인, 조은윤, 이정언, 남석진, 양정현

초록

Purpose: Sentinel lymph node (SLN) biopsy has replaced unnecessary axillary dissection in breast cancer surgery except when the nodes are positive for macrometastasis. But guidelines for isolated tumor cells (ITCs) found in SLNs has not yet been established and further study is ongoing. The goal of this study was to consider the implication of the isolated tumor cells found in the SLNs of Korean breast cancer patients.
Methods: Between September 2003 and March 2008, 985 primary breast cancer patients underwent SLN biopsy. On reviewing the medical records, 81 patients were found to have ITCs in SLNs without macrometastasis or micrometastasis. ITCs were detected by serial sectioning and immunohistochemistry.
Results: The mean number of detected SLNs was 3.5±1.7. Thirty three patients had multifocally distributed ITCs and 9 had ITCs in multiple SLNs whose N stage was N0 (i＋). Completion axillary dissection has been performed in 9 patients and 3 of them (33.3%) finally were found to be N1 or N1mi.
Conclusion: The characteristics of ITCs are not clear yet and their prognostic value is still under investigation. Until the significance of ITCs found in SLNs become definite, axillary dissection should be more aggressively considered.

영어초록

Purpose: Sentinel lymph node (SLN) biopsy has replaced unnecessary axillary dissection in breast cancer surgery except when the nodes are positive for macrometastasis. But guidelines for isolated tumor cells (ITCs) found in SLNs has not yet been established and further study is ongoing. The goal of this study was to consider the implication of the isolated tumor cells found in the SLNs of Korean breast cancer patients.
Methods: Between September 2003 and March 2008, 985 primary breast cancer patients underwent SLN biopsy. On reviewing the medical records, 81 patients were found to have ITCs in SLNs without macrometastasis or micrometastasis. ITCs were detected by serial sectioning and immunohistochemistry.
Results: The mean number of detected SLNs was 3.5±1.7. Thirty three patients had multifocally distributed ITCs and 9 had ITCs in multiple SLNs whose N stage was N0 (i＋). Completion axillary dissection has been performed in 9 patients and 3 of them (33.3%) finally were found to be N1 or N1mi.
Conclusion: The characteristics of ITCs are not clear yet and their prognostic value is still under investigation. Until the significance of ITCs found in SLNs become definite, axillary dissection should be more aggressively considered.

참고자료

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