乳腺癌的手术:基于证据的缓解在前置和后辅助设置中运行标题:手术的现代趋势
Woong Ki Park1, Seok Jin Nam1, Seok Won Kim1
1Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Journal of breast cancer
|January 30, 2026
概括
乳腺癌的手术正在缓和. 哨兵淋巴结活检 (SLNB) 和省略状淋巴结剖析 (ALND) 是安全的,即使有巨型转移,优化治疗以获得更好的患者结果.
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:
- 乳腺癌的手术已经从激进的清除演变为缓解.
- 哨兵淋巴结活检 (SLNB) 取代了状淋巴结剖析 (ALND),降低了发病率.
- 最近的试验质疑SLNB在精选患者中的必要性,有利于优化干预措施.
研究的目的:
- 审查乳腺癌中缓解关手术的证据.
- 分析哨兵淋巴结转移负担对治疗决策的影响.
- 在特定的患者群体中探索手术的潜在遗漏.
主要方法:
- 随机试验的综述,按哨兵淋巴结转移负担 (微转移,混合,宏转移) 分类.
- 对临床结节阴性患者的观察与SLNB进行比较的研究分析.
- 检查新辅助治疗数据和正在进行的试验,探索完全的手术遗漏.
主要成果:
- 缺失状淋巴结解剖 (ALND) 对于患有微转移或1-2阳性哨兵淋巴结 (SLNB) 的患者来说是安全的,当全身治疗和放射治疗进行时.
- 对于患有1-2个宏观转移的患者,ALND遗漏也安全.
- 在临床结节阴性,成像阴性瘤中,观察结果可能与SLNB无差.
- 完全忽略了手术正在被调查在新辅助设置的优秀响应者.
结论:
- 亚手术缓解是通过各种哨兵淋巴结转移负担的强有力的证据来支持的.
- 根据疾病生物学,全身疗法反应和患者的生活质量优化手术是当前的趋势.
- 进一步的研究正在进行中,有可能在精选的乳腺癌患者中完全省略手术.
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