Kaptan GÜLBEN, Mustafa YİĞİT, Uğur BERBEROĞLU

Is Minimum 10 Nodes Removed to Correctly Determine The Breast Cancer Patients Who Had Negative Axillary Status Sufficient?

Arka Plan: Bu çalışmanın amacı, aksiller disseksiyonda tüm aksillayı güvenli bir şekilde temsil edecek minimum lenf nodu sayısını beiiriemektir. Yöntem: Ekim 1999-Ağustos 2002 tarihleri arasında tedavi edilen 411 erken evre meme kanserli hastanın kayıtları retrospektif olarak değerlendirildi. Çıkarılan toplam aksiller lenf nodu sayısı, metastatik lenf nodu sayısı, tümör boyutu, grad ve lenfovasküler invazyon varlığı incelendi. Bulgular: Hastaların %60'ında aksiller lenf nodu metastazı saptandı. Çıkarılan ortalama lenf nodu sayısı 20.2 ± 0.4, metastatik lenf nodu sayısı ise 3.6 ± 0.3 olarak bulundu. Aksillasından toplam 6-15 lenf nodu ile 16 ve üzeri lenf nodu disseke edilen hastalar arasında metastatik lenf nodu oranı bakımından anlamlı fark olduğu tespit edildi (sırasıyla %45 ve %78). En yüksek aksiller metastaz oranı, 16-20 lenf nodu çıkarılan hastalarda saptandı (%68). Yirmi'den fazla lenf nodu çıkarılan grupta aksiller metastaz oranı daha yüksek değildi. Sonuçlar: Genel olarak aksi İlası negatif meme kanserli hastaları güvenle belirlemek için, aksiller disseksiyonla minimum 10 lenf nodu çıkarılması gerektiği kabul edilmekle beraber, bu çalışmanın sonuçlarına göre bu sayının en az 16 olması gerektiği ileri sürülebilir.

Anahtar Kelimeler:

Meme kanseri, lenf nodu, aksiller disseksiyon, metastaz.

Meme Kanserinde Aksilla Negatif Olguları Doğru Belirlemek İçin En Az 10 Lenf Nodu Çıkarılması Yeterli midir?

Background: The aim of this study is to determine the minimum number of lymph nodes that confidently represents the complete axilla in an axillary dissection. Methods: The medical records of 411 patients vvith early breast cancer treated betvveen October 1999 andAugust 2002 were evaluated retrospectively. Total number of axillary lymph nodes removed, number of metastatic nodes, tumoursize, grade, and presence of lymphovascular invasion were revievved. Results: Axillary node metastases were detected in 60% of patients. The mean number of nodes collected was 20.2±0.4, vvith a mean of 3.6 ± 0.3 metastatic nodes. There was a significant difference in terms of the rate of metastatic nodes betvveen the patients vvith 6-15 nodes removed and those vvith 16 or more removed, 45% and 78%, respectively. The highest rate of metastatic nodes was determined in patients vvith 16-20 nodes removed (68%). The rate of axillary metastasis was not higher in group vvith more than 20 nodes removed. Conclusions: Although it is generaiiy considered that minimum 10 lymph nodes should be removed in an axillary dissectin to confidently determine the patients vvith breast cancer who had negative axiiiary node status, according to the results of this study, hovvever, it might be stated that the number of lymph nodes collected should be minimum 16.

Keywords:

Breast cancer, lymph nodes, axillary dissection, metastasis.,

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