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摘要: 前哨淋巴结活检术(sentinel lymph node biopsy, SLNB)标志着乳腺癌淋巴结手术进入微创时代,循证医学I类证据支持SLNB是临床腋窝淋巴结阴性早期乳腺癌患者安全、有效的腋窝诊断技术,前哨淋巴结阴性及低肿瘤负荷患者行SLNB替代腋窝淋巴结清扫术后,腋窝淋巴结复发风险和并发症极低。作为乳腺癌区域淋巴结微创诊断技术,SLNB安全有效替代腋窝淋巴结清扫术应建立在规范化操作前提下。目前SLNB在我国早期乳腺癌患者中逐渐趋于规范化和普及化,本文将对临床实践中SLNB的适应证、示踪剂应用、学习曲线掌握、手术规范操作和组织标本处理等问题进行综述。Abstract: The minimally invasive era for lymph node surgery in breast cancer began with sentinel lymph node biopsy (SLNB). Evidence-based medicine class I evidence supports that SLNB is a safe and effective axillary staging technique for patients with clinically negative axillary lymph node early breast cancer. The risk of axillary lymph node metastasis and complications in breast cancer patients with negative/low tumor burden sentinel lymph nodes without axillary lymph node dissection is very low. As a minimally invasive staging technique for breast cancer regional lymph nodes, SLNB should be established as a standardized operation for safe and effective replacement of axillary lymph node dissection. At present, SLNB has gradually become standardized and popularized for early breast cancer patients in China. This article reviews the SLNB indications, tracer application, learning curve, standard operation and tissue management.
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