复发性乳腺癌患者对侧腋窝淋巴结转移：局部事件还是远处转移？,Oncology Research and Treatment

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复发性乳腺癌患者对侧腋窝淋巴结转移：局部事件还是远处转移？
Oncology Research and Treatment ( IF 2.0 ) Pub Date : 2021-01-13 , DOI: 10.1159/000513661
Yiraldine Herrera-Martínez ₁ , Irene Acevedo-Bañez ₂ , Álvaro De-Bonilla-Damiá ₂ , Paula Fernández-Rodríguez ₂ , José María Sousa ₃ , José M Jiménez-Hoyuela García ₂

Affiliation

简介：对侧腋窝淋巴结转移（CAM）是乳腺癌患者中一种罕见的临床疾病。它可以从原始原发肿瘤（IV期）的血行播散到异常的区域淋巴引流到对侧腋窝来解释。然而，根据目前的临床指南，无论其起源如何，CAM都被认为是转移性疾病。案例介绍：一名 68 岁女性因右侧乳腺癌复发就诊；淋巴闪烁扫描显示对侧腋窝（左侧区域）只有一个前哨淋巴结（SLN）。二十四小时后，患者接受了上内象限切除术和双侧选择性淋巴结活检。最终的病理分析显示一个左侧 SLN 中有一个对侧大转移灶 (#x3e;4 mm)。随后，进行了左侧二级淋巴结清扫术。目前，患者正在接受化疗，临床反应良好。讨论：由于术前淋巴显像显示对侧淋巴引流，我们的患者被认为是淋巴结阳性而不是转移性疾病。通过对临床淋巴结和 CAM 呈阴性的复发性乳腺癌患者进行术前扫描，有可能确定那些将从治愈性治疗中受益的病例。
肿瘤资源治疗

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Contralateral Axillary Lymph Node Metastasis in a Patient with Relapsed Breast Cancer: Locoregional Event or Distant Metastasis Disease?

Introduction: Contralateral axillary lymph node metastasis (CAM) is a rare clinical condition in patients with breast cancer. It can be explained from hematogenous spread from the original primary tumor (stage IV) to aberrant regional lymphatic drainage to the contralateral axilla. However, according to the current clinical guidelines, regardless of its origin, CAM is considered as metastatic disease. Case Presentation: A 68-year-old woman presented with relapsed right breast cancer; lymphoscintigraphy showed only one sentinel lymph node (SLN) in the contralateral axilla (left region). Twenty-four hours later, the patient underwent upper internal quadrantectomy and bilateral selective lymph node biopsy. The final pathological analysis revealed one contralateral macrometastasis (#x3e;4 mm) in one left SLN. Subsequently, second-level left lymphadenectomy was performed. Currently the patient is being treated with chemotherapy, with appropriate clinical response. Discussion: Our patient was considered to be node-positive rather than having metastatic disease since the preoperative lymphoscintigraphy demonstrated contralateral lymphatic drainage. Through preoperative scan in patients with relapsed breast cancer with clinically negative lymph nodes and CAM, it is possible to identify those cases that would benefit from therapy with curative intention.
Oncol Res Treat

更新日期：2021-01-13

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