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在明智地选择后,光线A与B对比:淋巴结手术是否会影响瘤结果?

Cynthia Ong1, Christian M Blue1, Jamal Khan1

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哨兵淋巴结活检 (SLNB) 没有改善光线B乳腺癌的老年妇女的结果. 省略SLNB可能对这些患者来说是安全的,因为结果更多地取决于瘤生物学和患者因素.

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科学领域:

  • 在瘤学瘤学.
  • 手术瘤学手术瘤学
  • 乳腺癌研究研究 乳腺癌研究

背景情况:

  • 选择明智的运动建议不对老年妇女 (≥70) 进行常规的哨兵淋巴结活检 (SLNB),这些妇女患有早期HR+,HER2-乳腺癌.
  • 光线B乳腺癌比光线A更具侵略性,但目前的指导方针对SLNB建议没有区分它们.

研究的目的:

  • 评估SLNB对患有HER2-阴性,激素受体阳性乳腺癌的老年妇女 (≥70) 癌症结局的影响,特别是比较Luminal B和Luminal A亚型.
  • 为了确定SLNB是否在Luminal B与Luminal A乳腺癌中提供生存益处.

主要方法:

  • 从2010年到2020年,对70岁以上的女性进行了临床结节阴性HR+乳腺癌的回顾性队列研究.
  • 通过基因表达,Ki67和/或分级来确定发光状态.
  • 主要终点:局部区域复发 (LRR),无病生存率 (DFS) 和整体生存率 (OS).

主要成果:

  • 对于光线A或光线B疾病,SLNB在LRR中没有显著差异.
  • 在光线A疾病中,SLNB与改善的DFS和OS相关,但在光线B疾病中并非如此.
  • 多变量分析表明年龄和瘤大小影响了DFS,而光质状态,年龄和并发症影响了OS,SLNB不是一个重要因素.

结论:

  • 在70岁以上的Luminal B乳腺癌患者中,SLNB可能会被省略,因为LRR类似于Luminal A.
  • 这一患者群的无病生存率和整体生存率主要受到瘤生物学,患者年龄和并发症的影响,而不是SLNB的使用.