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以往认为SLNB仅适用于单一病灶的早期乳腺癌,内乳淋巴结、多灶性/多中心乳腺癌、导管原位癌(DCIS)均不宜SLNB。本文主要对上述问题实行SLNB的可能性做一综述。内乳前哨淋巴结活检(IMSLNB)可提供腋窝外的淋巴结状态信息,尤其某些孤立IMLN受累患者可能改变术后辅助治疗策略。前哨淋巴结(SLN)是整个乳房组织的第一站引流的淋巴结而非针对于某一个病灶,这使多灶性/多中心乳腺癌患者行SLNB成为可能,可获得较满意成功率和准确率。SLNB不必用于所有DCIS患者,而对于伴浸润性癌高危因素如年轻、CNB诊断的DCIS、肿物较大(≥4cm)、高级别DCIS而且欲行乳房切除术的DCIS患者可考虑SLNB。
In the past that SLNB only applies to a single lesion of early breast cancer, internal mammary lymph node, multifocal / multicenter breast cancer, ductal carcinoma in situ (DCIS) are not SLNB. This article mainly reviews the possibility of implementing SLNB on the above issues. Intra-breast sentinel lymph node biopsy (IMSLNB) provides axillary lymph node status information, and in particular, some isolated IMLN-affected patients may alter postoperative adjuvant therapy strategies. Sentinel lymph node (SLN) is the first node of the entire breast tissue drainage lymph nodes rather than a focus on the disease, which makes multifocal / multicenter breast cancer patients with SLNB possible to obtain a more satisfactory success rate and accuracy. SLNB need not be used for all DCIS patients, but SLNB may be considered for DCIS patients with high risk of invasive cancer such as young, CNB-diagnosed DCIS, larger masses (> 4 cm), high-grade DCIS and mastectomy.